Thursday, 21 July 2016

Combining Drugs For Neuropathic Disease Treatment: Why Not?

Today's post from looks at a new treatment for fibromyalgia, which is a chronic and mysterious disease recently found to be linked to neuropathy by the fact that it is stimulated by the central nervous system (brain and spinal cord). It suggests that a combination of pregabalin (Lyrica) and duloxetine (Cymbalta) works very well at reducing the symptoms. The direct link to neuropathy is obvious as both drugs are used singularly to treat neuropathy symptoms. It has also been suggested in the past that combination therapies are the best options for severe neuropathic symptoms but many doctors are reluctant to go down that path because of side effects. The side effects should not be underestimated (especially pregabalin (Lyrica) which has such a bad name yet is still widely prescribed for many neuropathies but the idea of combining treatments is not a bad one and one worthy of consideration in discussion with your doctor or neurologist. Combinations excluding Lyrica may be best, to avoid unpleasant side-effects but surely other options can be considered - there are enough drug treatments to choose from and as they rarely work on their own, a combination which will block pain bearing signals in the sodium channels seems like a logical step forward.

Fibromyalgia: Doubling up to fight pain
Combining two drugs used to treat fibromyalgia safely improves patient outcomes, according to researcher 
Date:July 13, 2016 Source:Queen's University

Queen's University researcher Ian Gilron has uncovered a more effective way of treating fibromyalgia, a medical condition characterized by chronic widespread pain typically accompanied by fatigue, as well as sleep, mood and memory problems.

The results of the trial suggest that combining pregabalin, an anti-seizure drug, with duloxetine, an antidepressant, can safely improve outcomes in fibromyalgia, including not only pain relief, but also physical function and overall quality of life. Until now, these drugs have been proven, individually, to treat fibromyalgia pain.

"Previous evidence supports added benefits with some drug combinations in fibromyalgia," says, Dr. Gilron (Anesthesiology, Biomedical Sciences). "We are very excited to present the first evidence demonstrating superiority of a duloxetine-pregabalin combination over either drug alone."

Fibromyalgia was initially thought to be a musculoskeletal disorder. Research now suggests it's a disorder of the central nervous system -- the brain and spinal cord. Researchers believe that fibromyalgia amplifies painful sensations by affecting the level and activity of brain chemicals responsible for processing pain signals.

"The condition affects about 1.5 to 5 per cent of Canadians -- more than twice as many women as men. It can have a devastating on the lives of patients and their families," explains Dr. Gilron. "Current treatments for fibromyalgia are either ineffective or intolerable for many patients."

This study is the latest in a series of clinical trials -- funded by the Canadian Institutes of Health Research (CIHR) -- that Dr. Gilron and his colleagues have conducted on combination therapies for chronic pain conditions. By identifying and studying promising drug combinations, their research is showing how physicians can make the best use of current treatments available to patients.

"The value of such combination approaches is they typically involve drugs that have been extensively studied and are well known to health-care providers," says Dr. Gilron.

This new research was published in the journal Pain.

Dr. Gilron and his research team at Queen's are members of the SPOR Network on Chronic Pain. The national network, funded under Canada's Strategy for Patient-Oriented Research, directs new research, trains researchers and clinicians, increases access to care for chronic pain sufferers, and speeds up the translation of the most recent research into practice.

Story Source:

The above post is reprinted from materials provided by Queen's University. The original item was written by Anne Craig. Note: Materials may be edited for content and length.

Journal Reference:
Ian Gilron, Luis E. Chaparro, Dongsheng Tu, Ronald R. Holden, Roumen Milev, Tanveer Towheed, Deborah DuMerton-Shore, Sarah Walker. Combination of pregabalin with duloxetine for fibromyalgia. PAIN, 2016; 157 (7): 1532 DOI: 10.1097/j.pain.0000000000000558

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