Combination therapy for neuropathic pain

Gilron I,Bailey JM, et al. Morphone, gabapentin or their combination fo rneuropathic pain. NEJM 2005; 352: 1324-1334 (article) and editorial Raja SN, Haythornthwaite JA. Combination therapy for neuropathic pain-- which drugs, which combination, which patients: NEJM 2005; 352: 1373-5.

In the article, authors study 57 patients with diabetic neuropathy or postherpetic neuralgia, and found that the combination titrated concurrently achieved better analgesia at lower doses of each drug than either one as a single agent.

In clinical management, expert panels suggest that when relief with gabapentin is incomplete, to add a second agent, which may be an opiod.