Combining Drugs To Ease Neuropathic Pain

Today's post from sciencedaily.com (see link below) talks about something that many neuropathy patients see as being a logical development and that is combining drugs to achieve maximum effect. Doctors are reluctant to do this, especially where opioids are involved but for patients with severe neuropathic symptoms, single drug treatments are often ineffective and leave the patient still having to deal with unpleasant sensations every day. Doctors feel that the commonly used drugs for nerve pain are powerful enough without adding others to the mix and proceed along the lines of: if one doesn't work, try another one but don't pile on other chemicals at the same time. However, it's being proved that carefully controlled doses of two or more nerve pain suppressants can work better than anything else. In the case of this article, the use of nortryptiline and morphine together has been proved to be the best option yet for certain patients. Worth talking over with your doctor if your current treatment isn't working.

Easing the pain with drug combination
Date:April 7, 2015 Source: Queen's University
 
Summary:

Combining nortriptyline and morphine provides better pain relief than using either drug alone, according to a new study. "Chronic pain is an increasingly common problem and can exert disastrous personal, societal, and socio-economic impacts on patients, their families, and their communities," says the lead author of the study. "Current neuropathic pain treatments are ineffective or intolerable for many sufferers so this new evidence supporting the morphine-nortriptyline combination is important news for patients."

The combination of two well-known drugs will have unprecedented effects on pain management, says new research from Queen's.

Combining morphine, a narcotic pain reliever, and nortriptyline, an antidepressant, has been found to successfully relieve chronic neuropathic pain -- or a localized sensation of pain due to abnormal function of the nervous system -- in 87 per cent of patients, and significantly better than with either drug alone.

"Chronic pain is an increasingly common problem and can exert disastrous personal, societal, and socio-economic impacts on patients, their families, and their communities," says Ian Gilron, lead author of the study. "Current neuropathic pain treatments are ineffective or intolerable for many sufferers so this new evidence supporting the morphine-nortriptyline combination is important news for patients."

During the study, average daily pain was measured using a patient's numerical rating of pain on a validated scale from 0 -- 10. It was found that average daily pain before treatment was 5.6, which dropped to 2.6 when the patient was receiving the drug combination. On average, patients taking nortriptyline and morphine alone rated their pain at 3.1 and 3.4, respectively.

It was also found that common side effects for both drugs, which can include constipation and dry mouth, did not worsen during the combination treatment.

"It's important to remember that we don't want to completely eliminate patients' ability to sense pain as it's a warning system for us, but we do want to find the right balance of pain relief and drug side effects," says Dr. Gilron, a professor in Queen's School of Medicine and anesthesiologist at Kingston General Hospital. "Morphine and nortriptyline are excellent candidates for pain management because of the extensive research conducted on them, their low cost, and widespread availability all over the world."

In the double-blind, randomized crossover study, every patient had the opportunity to try every one of the three treatments: the combination, morphine alone and nortriptyline alone in each of the three six-week treatment periods. Throughout each treatment period, patients attended follow-up assessments to record their pain levels and side effects.

This research was published in PAIN, the highest impact pain journal globally.

Story Source:

The above story is based on materials provided by Queen's University. The original article was written by Rosie Hales. Note: Materials may be edited for content and length.

http://www.sciencedaily.com/releases/2015/04/150407171613.htm