A drug for psychiatric conditions may have a new use in treating inflammatory bowel disease if pilot data presented here November 8th at the meeting of the Society for Neuroscience, bear out in larger trials.
Bupropion lowered levels of tumor necrosis factor (TNF) in eight patients who were taking bupropion for depression, with seven entering the normal range for the inflammatory agent. Levels of TNF ranged from 20 to 1250 pg/mL before bupropion, and dropped to 14 to 2 pg/ml afterwards. One patient's levels remained elevated, at 94 pg/mL.
Larger studies are underway, in Crohn's disease, and in other diseases linked with TNF.
Prior publication by the investigators indicated that some patients taking the agent have remission of Crohn's symptoms. Another short paper in press duplicates the finding. Psoriasis apparently also improves with the drug treatment, according to another, recent paper.
"There are a lot of TNF-[related] diseases," said investigator Eric Altschuler, resident, rehabilitation medicine, Mt. Sinai Medical Center, New York, United States. "Obviously large, randomised trials are needed [to show the effect of bupropion on TNF is real]," said Dr. Altschuler, but, he added, "if this is true, [bupropion] is cheap, safe, and it's easy [to give]. Doctors have a good comfort level [with the drug]."
The investigators speculate that the result with TNF comes about through activation of dopamine, which increases cyclic adenosine monophosphate inside cells, thereby decreasing the manufacture of TNF by macrophages.
Dr. Altschuler is an inventor listed on a patent application for use of bupropion as a TNF-lowering agent, filed by the University of California. He is also an advisor to GlaxoSmithKline.
[Study title: Bupropion (Wellbutrin) lowers tumor necrosis factor-alpha (TNF) levels: Implications for disease treatment. Abstract 105.8]
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256DDA006B8EC6?OpenDocument&c=Neurologic%20Other&count=10
By Roberta Friedman, PhD
NEW ORLEANS, LA -- November 10, 2003 --