Bupropion for the treatment of neuropathic pain
Bupropion for the treatment of neuropathic pain. A short review.
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.
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.” 
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.
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.”
Although the data are somewhat thin, and sub optimal studies, even open studies exist . 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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