- Combination Therapy
Patients with neuropathic pain who have either failed to respond to monotherapy or exhibited only a partial response frequently receive combination therapies. Using lower doses of various classes of drugs may alleviate or prevent adverse drug effects that are observed at higher doses in monotherapy.
Combination therapies have been extensively studied, with studies focusing on their applications and finding varied results. The combination of gabapentin and an opioid was preferable to monotherapy or placebo, according to a meta-analysis of two studies. However, the combination was associated with higher dropout rates due to adverse effects.
A large study comparing high concentrations of duloxetine and pregabalin as monotherapy to lower doses in combination found no difference in efficacy or adverse effects. Due to the limited number of studies, there is little evidence to support specific medication combinations for neuropathic pain in patients.
