• Juan Esteban Correa-Morales, Laura Cuellar-Valencia, Nidia Mantilla-Manosalva, Elias Quintero-Muñoz, María Fernanda Iriarte-Aristizábal, Sara Giraldo-Moreno, and Luisa Fernanda Rodríguez-Campos.
• Universidad de La Sabana, (J.E.C.M., L.C.-V., N.M.-M., E.Q.-M., M.F.I.-A., L.F.R.-C.) Bogotá D.C., Colombia; Colombian National Cancer Institute, (J.E.C.M., L.C.-V., N.M.-M.) Bogotá D.C., Colombia. Electronic address: juancormo@unisabana.edu.co.
• J Pain Symptom Manage. 2023 Jan 1; 65 (1): e21e28e21-e28.

ContextFatigue is a predominant and distressing symptom in cancer and non-cancer conditions for which there is a paucity of recommendations for pharmacological interventions. Bupropion is a novel treatment whose efficacy and safety in the treatment of fatigue are unknown.ObjectivesThis study aimed to systematically assess the evidence on the efficacy and safety of bupropion in the treatment of fatigue in people with cancer and non-cancer conditions.MethodsPubMed, EMBASE, and Ovid Medline databases were searched up to July 26, 2022. Studies were included if they reported bupropion as an intervention for cancer and non-cancer-related fatigue and used an objective scale to assess symptom outcomes. Experimental and quasi-experimental studies in adult patients published in English were included.ResultsThis review reports on seven studies (three randomized studies, three non-randomized studies, and one case series) that enrolled a total of 584 patients. Bupropion was tested in five studies for treating cancer-related fatigue and in two studies for treating fatigue in non-cancer conditions. The reviewed studies were heterogeneous in relation to the scales used to assess fatigue. Six out of seven studies reported that bupropion significantly reduced the fatigue burden without causing major adverse effects. These positive results must be taken with caution caused by the small sample sizes and low quality of the studies reviewed.ConclusionBupropion may prove to be an effective and safe intervention for fatigue in cancer and non-cancer conditions. A high-quality randomized trial is warranted to test current preliminary results.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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