Bupropion anno 2010 recommended in review article

In a current (2010) review special emphesis was given to bupropion as a specific inhibitor of neuronal noradrenaline reuptake and at the same time a weak inhibitor of dopamine reuptake, 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 antidepressant and " several antidepressants have been efficacious in the management of chronic neuropathic pain, including the tricyclic antidepressants (particularly the tertiary-amine subtypes, such as amitriptyline, doxepin, and imipramine) as well as venlafaxine, bupropion, 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]

Some older studies supported the efficacy of bupropion.In one cross over trial forty-one patients with neuropathic pain were treated druring 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, and 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 suboptimal studies, even open studies exsist ^[5], one might consider bupropion in the treatment of neuropathic pain if other drugs fail to help.

From the Centre for the study and treatment of neuropathic pain and neuropathy in Soest, the Nertherlands

This site helps patients and treating physicians, neurologists, anesthesiologists and other pain specialists to find the best and most up to date research findings related to neuropathy and neuropathic pain and the treatment thereof.

In our centre we are specialised in treating patients suffering from neuropathic pain and neuropathy following an Integrated Medicine concept. Part of our activities are within the field of consultation. We assist pharmaceutical companies in R&D strategies related to finding new drugs to treat neuropathic pain and neuropathy.

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

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