¿Tiene fundamento la combinación de gabapentina y pregabalina en el tratamiento del dolor neuropático? Una revisión narrativa crítica.
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| Title: | ¿Tiene fundamento la combinación de gabapentina y pregabalina en el tratamiento del dolor neuropático? Una revisión narrativa crítica. |
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| Alternate Title: | Does the combination of gabapentin and pregabalin have a rationale in the treatment of neuropathic pain? A critical narrative review. |
| Authors: | Alcántara-Montero, Antonio1 (AUTHOR) a.alcantara.montero@hotmail.com |
| Source: | Dolor: Investigación, Clínica & Terapéutica. 2026, Vol. 41 Issue 2, p38-46. 9p. |
| Subjects: | Gabapentin, Pregabalin, Treatment effectiveness, Clinical trials, Drug interactions, Medical research, Drug toxicity, Neuralgia |
| Abstract (English): | Neuropathic pain is a complex condition to manage, and although gabapentin and pregabalin are used as firstline alternatives, their combined use is not supported by clinical guidelines or robust evidence. The aim of this critical narrative review was to examine the pharmacological plausibility, available clinical evidence, and practical implications of this combination. A comprehensive search was conducted in PubMed/MEDLINE, Embase, Scopus, and Google Scholar, supplemented by grey literature and crossreferenced sources. The search identified only one recent randomized clinical trial with substantial methodological limitations, alongside a very small number of preliminary, lowquality studies. Overall, the available evidence remains scarce, heterogeneous, and methodologically weak. Current data indicate limited pharmacological plausibility, weak clinical signals, and a documented risk of additive toxicity, preventing this combination from being considered an evidencebased strategy and restricting its potential use to highly selected refractory cases under close clinical supervision. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | El dolor neuropático es una entidad de manejo complejo y, aunque gabapentina y pregabalina se emplean como alternativas de primera línea, su uso combinado no está respaldado por ninguna guía clínica ni por evidencia sólida. El objetivo de esta revisión narrativa crítica fue analizar la plausibilidad farmacológica, la evidencia clínica disponible y las implicaciones prácticas de dicha combinación. Se realizó una búsqueda exhaustiva en PubMed/MEDLINE, Embase, Scopus y Google Scholar, complementada con literatura gris y referencias cruzadas. La búsqueda identificó únicamente un ensayo clínico aleatorizado reciente con importantes limitaciones metodológicas, junto con un número muy reducido de estudios preliminares de baja calidad. En conjunto, la evidencia disponible sigue siendo escasa, heterogénea y metodológicamente limitada. Los datos actuales muestran una plausibilidad farmacológica reducida, señales clínicas débiles y un riesgo documentado de toxicidad aditiva, lo que impide considerar esta combinación como una estrategia basada en evidencia y restringe su posible uso a casos refractarios muy seleccionados y bajo estrecha supervisión. [ABSTRACT FROM AUTHOR] |
| Copyright of Dolor: Investigación, Clínica & Terapéutica is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
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| Abstract: | Neuropathic pain is a complex condition to manage, and although gabapentin and pregabalin are used as firstline alternatives, their combined use is not supported by clinical guidelines or robust evidence. The aim of this critical narrative review was to examine the pharmacological plausibility, available clinical evidence, and practical implications of this combination. A comprehensive search was conducted in PubMed/MEDLINE, Embase, Scopus, and Google Scholar, supplemented by grey literature and crossreferenced sources. The search identified only one recent randomized clinical trial with substantial methodological limitations, alongside a very small number of preliminary, lowquality studies. Overall, the available evidence remains scarce, heterogeneous, and methodologically weak. Current data indicate limited pharmacological plausibility, weak clinical signals, and a documented risk of additive toxicity, preventing this combination from being considered an evidencebased strategy and restricting its potential use to highly selected refractory cases under close clinical supervision. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 02140659 |
| DOI: | 10.24875/DOL.M26000039 |
