Elsevier

The Journal of Pain

Volume 12, Issue 2, February 2011, Pages 157-166
The Journal of Pain

Critical Review
Combination Drug Therapy for Chronic Pain: A Call for More Clinical Studies

https://doi.org/10.1016/j.jpain.2010.07.006Get rights and content
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Abstract

Chronic pain is a debilitating clinical condition associated with a variety of disease entities including diabetic neuropathy, postherpetic neuralgia, low back pathology, fibromyalgia, and neurological disorders. For many general practitioners and specialists, managing chronic pain has become a daunting challenge. As a modality of multidisciplinary chronic pain management, medications are often prescribed in combinations, an approach referred to as combination drug therapy (CDT). However, many medications for pain therapy, including antidepressants and opioid analgesics, have significant side effects that can compound when used in combination and impact the effectiveness of CDT. To date, clinical practice of CDT for chronic pain has been based largely on clinical experiences. In this article, we will focus on (1) the scientific basis and rationales for CDT, (2) current clinical data on CDT, and (3) the need for more clinical studies to establish a framework for the use of CDT.

Perspective

More preclinical, clinical, and translational studies are needed to improve the efficacy of combination drug therapy that is an integral part of a comprehensive approach to the management of chronic pain.

Key words

Chronic pain
neuropathic pain
multimodal fibromyalgia
polypharmacy
drug therapy
clinical trial

Cited by (0)

Supported by NIH RO1 grants NS45681, DA22576, DE18214, DE18538, DE018252, NS063010, and P20 grant DA26002.

The authors declare no conflict of interest.