Results of a new study appearing in the journal Pain report that the combined administration of morphine and nortriptyline produces significantly better relief of neuropathic pain than is achieved with either medication alone. The study was conducted by researchers at Queen’s University School of Medicine, Kingston, ON. Lead author Ian Gilron, MD, MSc, FRCPC, noted "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." Dr Gilron further observed that the low cost and worldwide availability of these common medications make them attractive candidates for pain management.
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. 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. A press release from the University about the study findings may be read here. The journal abstract, with information on accessing the full article, may be read here.