Goodnick, P J, Sandoval, R, Brickman, A et al. · Biological psychiatry · 1992 · DOI
This study tested whether bupropion, an antidepressant medication, could help ME/CFS patients who didn't benefit from or couldn't tolerate fluoxetine (another antidepressant). Nine patients took 300 mg of bupropion daily for 8 weeks and showed significant improvement in depression symptoms. The researchers also found that bupropion appeared to affect certain brain chemicals and immune markers in ways that correlated with symptom improvement.
This study addresses a clinically important problem—ME/CFS patients who don't respond to first-line antidepressants—and suggests bupropion may be an effective alternative. The mechanistic findings linking symptom improvement to specific neurochemical and immune markers provide potential biomarkers for treatment response and insights into ME/CFS pathophysiology.
This study does not establish that dopamine dysregulation is the primary cause of ME/CFS, only that bupropion-induced changes in dopamine-related compounds correlate with symptom improvement in some patients. The open-label design means results may reflect placebo response, observer bias, or natural fluctuation rather than true drug effect. The small sample size (n=9) limits generalizability, and findings may not apply to all ME/CFS patients or those who tolerate fluoxetine.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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