BuNeP-SCI: Bupropion for neuropathic pain after spinal cord injury

Led by the Spinal Cord Injury Centre of Western Denmark

This project aims to tackle severe, long-lasting nerve pain (neuropathic pain) that often develops after a spinal cord injury (SCI), a condition for which current treatments provide only modest relief and can have significant side effects. The study will investigate whether an existing medication called bupropion can effectively and safely reduce this type of pain.

Bupropion is already approved in many countries to treat depression and help people stop smoking, and preliminary studies suggest it may also relieve other types of nerve pain. Its potential benefit is thought to come from its ability to boost the activity of dopamine and noradrenaline, neurotransmitters involved in the body’s natural, built-in pain-control pathways. Because bupropion is an established drug with a well-known safety profile, a positive result could be integrated into clinical practice much faster than a new medication, offering a quicker path to improved quality of life for people with SCI.

The study, will be a randomised, double-blind, crossover trial. Participants will receive both bupropion and a placebo (a "dummy pill") for six-week periods in a random order, allowing for a direct comparison of the drug's effectiveness. A key innovative aspect of the project is to explore whether a test of an individual's own pain-modulating capacity, known as conditioned pain modulation (CPM), can predict who is most likely to respond to the treatment.

This international project is led by Dr Jan Rosner, a consultant neurologist at the Spinal Cord Injury Centre of Western Denmark and the Danish Pain Research Centre at Aarhus University. He is collaborating with Professor Nanna Finnerup, Director of the Danish Pain Research Centre and Dr Harriet Kemp, a pain medicine consultant and senior lecturer at Imperial College London. By potentially providing a new treatment option and a way to personalise pain management, this research seeks to bring substantial relief to individuals with SCI, improving their physical and emotional well-being.

The study is due to commence in early 2026, and SMSR is funding a PhD student as a core part of the project.