Question regarding "Bupropion" (or "Wellbutrin") for Neuropathic pain
 

Hi Gang:

Over the years, I have used Cymbalta with moderate success for Neuropathic pain (especially Small Fiber).

The only side effect that I have encountered is delayed orgasm, which is very frustrating.

I recently read online that "Bupropion" (or "Wellbutrin") was shown in a number of studies to be effective for neuropathic pain relief without the sexual side effects of Cymbalta.

It was also shown to be useful in weight loss as a nice side effect.

Can anyone who is knowledgable about this drug share their knowledge. Could this drug actually be an effective replacement for Cymbalta without the sexual side effects?

I know that it is not an "SNRI" like Cymbalta, so I was surprised to read that it may be effective for treating neuropathic pain as opposed to depression alone.

Many thanks!

David

Some people find Wellbutrin works for PN pain. It works on dopamine primarily which does not have the well known connection for the serotonin central system the brain uses in pain perception. Increasing dopamine may improve attitude and confidence and make pain issues less prominent for some people.

But it is true that Wellbutrin does not affect sexual functioning as much as the other types do. Some people with sensitive cardiac functions may get a type of palpitations from Wellbutrin... but not all. Dopamine is a stimulant for the heart under some circumstances.

You'll just have to try it and see.

Many thanks for your insights!

If Wellbutrin is going to work for neuropathic pain, then how long would you expect it would take to work?

Cymbalta seems to take two weeks or so after you begin taking the full-strength 60mg dose before seeing an effect (I always taper-up with the first week at 30mg to avoid side effects).

I would give the Wellbutrin a month.

Watch for increased heart rate...that is the most common reason people discontinue.

That actual antidepressant actions will be slow to appear though like with other antidepessants.

People with low dopamine levels will feel energized and more confident as first changes. People with high dopamine already, may get the palpitations.( I saw many people complain of this heart rate effect over the years).

Some people believe Wellbutrin has mixed actions. These drugs can get pretty complicated to understand.

http://en.wikipedia.org/wiki/Bupropion

The anti-inflammatory actions mentioned in this article are fairly new.
If your PN has an inflammatory component...you may see improvement.

I was taking Wellbutrin for a short while and mentioned to the neurologist and gp that it was helping with my pain levels in my feet especially at night with throbbing, burning, stabbing etc. This was before studies were done showing it helped with nerve pain and they just looked at me and said we never heard that before. I used to call it the poor man's viagara. It worked pretty well for me for a while, until the type of pain i had morphed into deep bone pain.

... many thanks for the feedback!

David

Dopamine increases sensation. Increasing sensation, instead of blunting it with Serotonin enhancing drugs would seem more preferable to rebuilding nerves. In experimenting with both sides of the spectrum, I found that my neuropathy was worse on medications that were too pro-Serotonin as I was blind to my pain triggers(like laying a certain way for instance).

On the flipside, too much dopamine may cause anxiety and inability to relax. Finding your middle ground is the best solution and tipping the scales a little in the Dopamine direction. You can even do this by adding Blueberry, Pomegranate, and other fruit extracts to your regimen. Vitamin D or Methyl B-12 are serotonin enhancing and can cover those bases. You can enhance Serotonin levels with Vitamin D and Methyl B-12 amongst other routes.

I do take the Methy B-12 5000 mcg and also Vitamin D-3 2000 IU per day. Many thanks for your imput!

David

Apollo,

I was prescribed Bupropian along with other medications this past fall and winter for neuropathic pain in my feet. These included nuerontin, celebrex, lexapro, lyrica, indomethacin, amitryptilene and desipramine. I consequently developed undesirable side effects and discontinued all.

In retrospect I feel like the lyrica and the tricyclics were the root cause of the bad side effects, but I felt it was best to stop all the medications just to make sure.

I plan to start taking Bupropian again next week. It DID seem to help me with my stress and pain levels before I discontinued it.