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WCN: Stubborn Neuropathic Pain Responds to Buproprion By Richard Robinson Special to DG News LONDON, ENGLAND -- June 22, 2001 -- The antidepressant buproprion (Wellbutrin) is an effective pain treatment for patients with long-standing neuropathic pain resistant to other therapies. These findings arise from a randomized, double-blind, placebo-controlled, crossover trial presented by Dr. Marilyn Semenchuck of the Department of Neurology at University of Arizona, Tucson, who presented her work at the 17th World Congress of Neurology in London, June 17-22, 2001. "Chronic neuropathic pain has been shown to be responsive to sustained-release buproprion in an open-label trial," said Dr. Semenchuck, but this treatment has never been tested against placebo. Forty-one patients were enrolled in this trial, with a median pain duration of four years, "suggesting that spontaneous resolution during this three-month study would be unlikely," she noted. Patients received either placebo or buproprion at 150 mg/day for one week, followed by 300 mg/day for five weeks, and then crossover to the other arm of the trial. The primary outcome measure was the weekly mean of patient-rated pain intensity score,. Secondary outcomes were patient-rated global relief at the end of each treatment, and the change in Wisconsin Brief Pain Inventory (WBPI) score, also recorded at the end of each treatment and compared to baseline. Results showed that buproprion decreased weekly pain scores by 10-15 percent in each patient group for weeks two through six of treatment (p<0.001). Dr. Semenchuck pointed out that while this may seem relatively modest, "to a patient with chronic neuropathic pain, this is a very meaningful difference." Significant improvements were also seen on each element of the WBPI, including general activity, normal work, and life enjoyment. Side effects included dry mouth in a third of patients, as well as headache and insomnia, all of which tended to recede with treatment but, Dr. Semenchuck cautioned, could have contributed to unblinding. "Our results show that sustained-release buproprion may be an effective treatment for neuropathic pain," she concluded, and added that all patients chose to continue on open-label drug after the study ended. E-mail this page to a friend or colleague! To print, use this version