After a below knee amputation, pain was successfully remitted with combination of duloxetine and pregabalin.
Gen Hosp Psychiatry. 2010 March – April;32(2):228.e5-228.e7.
A presumed case of phantom limb pain treated successfully with duloxetine and
pregabalin.
Spiegel DR, Lappinen E, Gottlieb M. abstract here
- below knee amp for pain control post embolic clots from iliac artery
- duloxetine 30 mg to start – then 60 mg
- pregabalin 50 mg three time/day(TID) to start then 100 TID, then 150 AM and 300 hs. (bedtime)
- pain was burning – went from 7/10 to 3/10 and patient no longer needed morphine.
- patient had mood issues which they say “comorbid major depressive disorder (MDD), an illness itself which has a mean prevalence of painful symptoms in as much
as 65% of patients [17]. Rates of MDD in patients with limb loss have been reported in 35–42% of this population. 17 = Greist JH, Greden JF, Jefferson JW, Grivedi MH. Depression and pain. J Clin Psychiatry 2008;69(12):1970–8.
Comment – looks like a god combo to use for any postop pain issue – though both drugs are expensive and not on drug pain…