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Can Adding Carbamazepine to Morphine Therapy Result in Less Pain & Lower Opioid Dosage?
A study recently published in the journal PlosOne has demonstrated that combination morphine and carbamazepine therapy is more effective than morphine monotherapy in managing neuropathic pain. According to the study’s authors, over-stimulation of inflammatory nerve cells by a morphine metabolite can dampen the analgesic effects of morphine and even cause pain in neuropathic pain models (Carbamazepine Potentiates the Effectiveness of Morphine in a Rodent Model of Neuropathic Pain).
Researchers showed that carbamazepine, an antiepileptic drug, can reduce inflammatory activity in nerve cells that are thought to be over-stimulated by morphine-3-glucuronide, an active metabolite of morphine. Using a rodent model, researchers conducted in-vitro and in-vivo experiments to assess the cellular effects of combination carbamazepine and morphine therapy. In-vitro experiments showed that carbamazepine can prevent over-stimulation of the inflammatory response in nerve cells caused by morphine-3-glucuronide. In the in-vivo experiment, combination morphine and carbamazepine therapy alleviated pain 28 days after injury, whereas morphine monotherapy required increasing the dosage over the same time period.
The authors noted that additional studies are underway to investigate the effects of adding carbamazepine or related compounds to morphine neuropathic pain therapies. Currently, researchers at the Indiana University Melvine and Bren Simon Cancer Center are testing the combination of morphine and oxcarbazepine, an antiepileptic similar in structure to carbamazepine, among patients in a small clinical trial.
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