GOOD NEWS - Effective Treatment for Neuropathic Pain

[antiquity]

Effective Treatment for Neuropathic Pain

Nov. 13, 2001 (Ivanhoe Newswire) - Patients suffering from neuropathic pain may benefit from a drug that may provide greater relief and fewer side effects than traditional treatments.

Researchers from the University of Arizona in Tucson tested the antidepressant bupropion SR (sustained-release) for the treatment of neuropathic pain. Neuropathic pain is caused by a disturbance of the peripheral or central nervous system and leads to symptoms of shooting and burning sensations, numbness and tingling. While tricyclic antidepressants are the common form of treatment for neuropathic pain, many patients stop taking these drugs because they are either not effective or produce intolerable side effects.

More than 40 patients with neuropathic pain were enrolled in the study. Researchers found 73 percent, or about 30 patients, reported improved or much improved pain after 6 weeks of taking a daily dose of bupropion SR. They add 90 percent of patients say their pain was worse or unchanged while taking placebo.

Many experts believe when depressed patients who also suffer from neuropathic pain are given antidepressants; their pain is often reduced. Researches believe the effect of the drug may be due to alleviating the depression, not the cause of the pain itself. However, researchers in the current study enrolled only non-depressed patients and still found a beneficial effect. Marilyn Semenchuk, Pharm.D., from the University of Arizona, is quoted as saying, "By using non-depressed patients, the previous argument doesn't hold."

SOURCE: Neurology, 2001;57:1583-1588

[calico]

I think bupropion is the generic name for Wellbutrin. I've been taking Wellbutrin SR for several years. There has been NO CHANGE in my pain since taking it, but I believe my ABILITY TO COPE with the pain has improved. These are very different things.

For example, pre-Wellbutrin, if my pain escalated, so would my depression, utter hopelessness and wish to leave the planet. Now when my pain escalates, I'm BETTER ABLE to rationalize that "this too shall pass" and know that if I just sit down and put my arms in my lap that the pain will subside to an endurable level. I'm GENERALLY able to do this without sinking into complete hopelessness. This is definitely an improvement, but not a lessening of the condition which causes my pain to spike (central pain exacerbated by use of my arms) or the pain level when it does spike. Is this making any sense? It's simply an ability to better cope with the pain without sinking into hopelessness, not an improvement in the pain itself. In my case, it decreases SUFFERING, but it does not decrease pain.

I'm very dubious about professional assessments of whether or not people in chronic pain are depressed. There are different kinds, levels, effects and sources of depression. I expect that these patients didn't fit into the clinicians' narrow depression boxes, so they were judged not depressed. Chronic pain will cause changes in brain chemistry whether one calls that depression or not.

Calic

[David Berg]

The first thing that strikes me is that bupropion is a common enough drug that if it was a silver bullet, then more info would have come out before now.

At least one central pain patient has expressed the opinion to me that anti-depressant may help central pain because they, in general, help to "quiet" the nervous system, thereby reducing stress on the system. This could well lead to some degree of relief, so I can imagine that it's possible for this sort of drug to help manage neuropathic pain, aside from the anti-depressant properties.

One more thought...someone with a serious case of neuropathic pain is fairly likely to have some degree of depression.

David Berg