title: Bupropion for fatigue and as a tumor necrosis factor-alpha lowering agent in primary biliary cirrhosis.
abstract: Primary biliary cirrhosis (PBC) is a chronic cholestatic disease which can often be severe, progressive and necessitate liver transplantation. The cause of PBC is not known, and treatments other than liver transplantation are often not effective. Among the more common and troublesome symptoms of PBC is fatigue. The etiology of fatigue in PBC is not well-understood, and there is no known treatment for it. Here, we suggest that for a number of reasons that the safe and commonly used oral antidepressant bupropion might be effective for fatigue in PBC: (1) increased monoaminergic and dopaminergic tone to combat fatigue, (2) treatment of concomitant depression, (3) in general for PBC as a tumor necrosis factor-alpha (TNF) lowering agent, if TNF is eventually found to play a role in PBC pathogenesis.
authors.affiliation: Mount Sinai School of Medicine, 1425 Madison Avenue, Box 1240, New York, NY 10029, USA. eric.altschuler@mssm.edu
authors.forename: Eric Lewin
authors.initials: EL
authors.lastname: Altschuler
authors.forename: Richard E
authors.initials: RE
authors.lastname: Kast
mesh_terms: D005221:Fatigue / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000378:metabolism*; D010166:Palliative Care / Q000379:methods*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D014409:Tumor Necrosis Factor-alpha