Effectiveness of Extended-Release Bupropion and Duloxetine on Pelvic Pain and Sexual Function among Patients with Chronic Prostatitis/Chronic Pelvic Pain

Abstract

Background: This study aimed to compare the efficacy of the two antidepressants, duloxetine and bupropion, on pelvic pain in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Materials and methods: This single-blind clinical trial was conducted on 68 CP/CPPS patients. The patients with CP/CPPS received either an extended-release formulation of 150 mg/day bupropion (bupropion group) or duloxetine 30 mg/day for 12 weeks (duloxetine group). The pain, depression (using the Hospital Anxiety and Depression Scale (HADS)), quality of life (QoL), and sexual dysfunction scores were evaluated and compared before the intervention and after 4, 12, and 16 weeks of intervention in both groups.

Results: The pain score in the duloxetine group was significantly lower than the bupropion group after 12 and 16 weeks of intervention (P value <0.05). The mean HADS and QoL scores at baseline and after 4, 12, and 16 weeks of intervention had insignificant differences between the two groups (P value >0.05) but improved in both groups. After 4 and 12 weeks of intervention, sexual dysfunction scores in the duloxetine group were higher than those in the bupropion group (P value <0.05).

Conclusions: Depression and anxiety scores were significantly reduced in both groups. Sexual function was improved in the bupropion group compared with the duloxetine group, while pain scores improved significantly in the duloxetine group. Therefore, proposing the appropriate treatment based on the experienced complications of CP/CPPS is the key element of the management of these patients; however, further studies are required to compare the long-term effects of these two regimens on CP/CPPS patients' concerns.

Keywords: Bupropion; chronic prostatitis with chronic pelvic pain syndrome; depression; duloxetine; pain; quality of life; sexual function.

Figure 1

Consort flowchart

Figure 2

Mean decrease in VAS and pain scores between the two groups at the beginning, fourth, twelfth, and 16 weeks of the study. C1: Changes in mean VAS and pain scores after a 4-week intervention. C2: Changes in mean VAS and pain scores after a 12-week intervention. C3: Changes in the mean VAS and pain scores after a 16-week intervention

Figure 3

Mean changes in anxiety and depression scores between the two at the beginning, fourth, twelfth, and 16 weeks of the study. C1: Changes in mean anxiety and depression scores after 4 weeks. C2: Changes in mean anxiety and depression scores after 12 weeks. C3: Changes in mean anxiety and depression scores after 16 weeks

Figure 4

Mean changes in sexual function and quality-of-life scores between the two groups at the beginning, fourth, twelfth, and 16 weeks of the study. C1: Changes in the means of sexual function and quality-of-life scores at 4 weeks after the intervention. C2: Changes in the means of sexual function and quality-of-life scores at 12 weeks after the intervention. C3: Changes in the means of sexual function and quality-of-life scores at 16 weeks after the intervention