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Treatment of Atopic Dermatitis and Psoriasis Vulgaris With Bupropion-SR: A Pilot Study

From the Departments of Psychiatry (J.G.M., E.T.), Dermatology (S.B.), and Biostatistics (C.K.), the University of Alabama at Birmingham School of Medicine, Birmingham, AL.

Address reprint requests to: Jack G. Modell, Professor of Psychiatry, University of Alabama at Birmingham School of Medicine, 1700 7th Avenue South, Room 219, Birmingham, AL 35294-0018. Email: jgmodell{at}earthlink.net

OBJECTIVE: To determine whether the antidepressant bupropion may be useful in treating atopic dermatitis and psoriasis in nondepressed patients.

METHOD: Ten nondepressed subjects with atopic dermatitis and 10 with psoriasis completed a single-track, open-label treatment protocol with bupropion-SR in doses of 150 mg/day and 300 mg/day, administered sequentially for 3 weeks each, followed by a 3-week wash-out. Treatment response was assessed at the end of each 3-week period.

RESULTS: Six of the 10 subjects with atopic dermatitis showed a reduction in affected body surface area by the end of 6 weeks of bupropion treatment, with affected area increasing toward the prestudy baseline in all responders following bupropion discontinuation—a highly significant treatment effect (p = .0003). Of the 10 subjects having psoriasis, improvement over baseline after 6 weeks of treatment was seen in eight subjects, with coverage increasing toward the prestudy baseline in the responders following bupropion discontinuation (p = .001). Average reduction in affected area in the responders at week 6 of treatment was approximately 50% in both groups.

CONCLUSIONS: The generally good tolerability and relative safety of bupropion-SR makes a trial of this agent worthwhile in patients with atopic dermatitis or psoriasis who have failed treatment with more conventional medications. Normalization by bupropion of potentially causative neuroendocrine, immunologic, or catecholaminergic abnormalities in both of these dermatologic disorders is a possible mechanism of action for the observed salutary effects of this drug on our subjects’ skin disease.

Key Words: antidepressant, • atopic dermatitis, • bupropion, • eczema, • psoriasis.

Abbreviations: ANCOVA = analysis of covariance;; bupropion-SR = bupropion sustained-release formulation (GlaxoSmithKline Pharmaceuticals);; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition;; hCRH = human corticotrophin-releasing hormone;; HPA = hypothalamic-pituitary-adrenal.

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