Bupropion for the treatment of neuropathic pain

Bupropion for the treatment of neuropathic pain. A short review.

142707279-Margarita-Gorskaya-Dreamstime-INP Bupropion for the treatment of neuropathic pain

In a (2010) review special emphasis was given to Bupropion as a specific inhibitor of neuronal nor adrenaline re uptake and at the same time a weak inhibitor of dopamine re uptake. Which according to the authors might be of some promise in the treatment of neuropathic pain.[1]

Although there are not many studies available we can find comparable statements, as Bupropion is an anti-depressant and:

  • several anti-depressants have been efficacious in the management of chronic neuropathic pain, including the tricyclic anti-depressants (particularly the tertiary-amine sub types, such as Amitriptyline, Doxepin, and imipramine) as well as Venlafaxine and duloxetine.” [2]

However, in the mixed low back pain syndrome, were neuropathic mechanisms play a role, Bupropion a recent trial found no evidence of efficacy in patients with chronic low back pain.[3]

Pain relief was improved

Some older studies supported the efficacy of this medicine. In one cross over trial forty-one patients with neuropathy were treated during 6 weeks with either 150 mg Bupropion SR or placebo.

If treated with Bupropion SR, neuropathic pain relief was improved or much improved in 30 (73%) patients. One of these patients became pain-free. Side effects were primarily dry mouth, insomnia, headache, gastrointestinal upset, tremor, constipation, and dizziness.

The conclusion of the authors was: “This placebo-controlled crossover trial showed that Bupropion SR (150-300 mg daily) was effective and well tolerated for the treatment of neuropathic pain.”[4]

Although the data are somewhat thin, and sub optimal studies, even open studies exist [5]. One might consider Bupropion in the treatment of neuropathic pain if other drugs fail to help.

February 2010, Jan M. Keppel Hesselink, MD, PhD

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[1] Shah TH, Moradimehr A. | Bupropion for the treatment of neuropathic pain. | Am J Hosp Palliat Care. | 2010 Aug;27(5):333-6. Epub 2010 Feb 24.

[2] Sansone RA, Sansone LA. | Pain, pain, go away: antidepressants and pain management. | Psychiatry (Edgmont). | 2008 Dec;5(12):16-9.

[3] Katz J, Pennella-Vaughan J, Hetzel RD, Kanazi GE, Dworkin RH. | A randomized, placebo-controlled trial of bupropion sustained release in chronic low back pain. | J Pain. | 2005 Oct;6(10):656-61.

[4] Semenchuk MR, Sherman S, Davis B. | Double-blind, randomized trial of bupropion SR for the treatment of neuropathic pain. | Neurology. | 2001 Nov 13;57(9):1583-8.

[5] Semenchuk MR, Davis B. | Efficacy of sustained-release bupropion in neuropathic pain: an open-label study. | Clin J Pain. | 2000 Mar;16(1):6-11.

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