Combination Drug Therapy for Pain following Chronic Spinal Cord Injury

Author:

Hama Aldric1,Sagen Jacqueline1

Affiliation:

1. The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, 1095 SW 14th Terrace, Miami, FL 33136, USA

Abstract

A number of mechanisms have been elucidated that maintain neuropathic pain due to spinal cord injury (SCI). While target-based therapeutics are being developed based on elucidation of these mechanisms, treatment for neuropathic SCI pain has not been entirely satisfactory due in part to the significant convergence of neurological and inflammatory processes that maintain the neuropathic pain state. Thus, a combination drug treatment strategy, wherein several pain-related mechanism are simultaneously engaged, could be more efficacious than treatment against individual mechanisms alone. Also, by engaging several targets at once, it may be possible to reduce the doses of the individual drugs, thereby minimizing the potential for adverse side effects. Positive preclinical and clinical studies have demonstrated improved efficacy of combination drug treatment over single drug treatment in neuropathic pain of peripheral origin, and perhaps such combinations could be utilized for neuropathic SCI pain. At the same time, there are mechanisms that distinguish SCI from peripheral neuropathic pain, so novel combination therapies will be needed.

Funder

Craig H. Neilsen Foundation

Publisher

Hindawi Limited

Subject

Anesthesiology and Pain Medicine,Clinical Neurology

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