People who suffer from neuropathic pain often struggle in vain to find relief from the agony. Now, a new Canadian study suggests relief might be out there already, in the combination of two commonly-prescribed drugs.

Researchers from Queen's University in Kingston, Ont., have found that an anti-seizure drug and an antidepressant taken together is a more effective treatment than either of the medications alone.

Neuropathic pain has been described as burning, stabbing, and unrelenting pain that can be felt everywhere. The chronic condition often follows nerve damage from diabetes, back injury, shingles infections and other causes.

Debbie Loder is among the one per cent of Canadians who suffer from chronic neuropathic pain. In her case, it was triggered by her type 2 diabetes and stopped her from ever getting a full night's sleep.

"There would be stabbing pains through the night," she remembers. "The longer I was laying down, the worse the pain."

While patients sometimes get pain relief from morphine and other of the strongest pain relievers, the Queen's team says a better option might come from combining the anti-seizure drug gabapentin and the antidepressant nortriptyline.

Dr. Ian Gilron, director of Clinical Pain Research for Queen's Departments of Anesthesiology, and Pharmacology & Toxicology and an anesthesiologist at Kingston General Hospital, found that not only do patients report pain relief, they also report better sleep - something not seen in morphine treatments.

"That's a very important issue for this group of patients, whose debilitating, unrelenting pain often interferes with normal sleep," Gilron said in a news release, announcing the study's findings which are published in The Lancet.

Each of the drugs has been recommended for neuropathic pain relief on their own. However, the drugs rarely reduce pain by more than 60 per cent and only about half of patients find they work at all, in part because the dosages have to be capped because they carry serious side effects at high doses.

But Gilron found that combining the two allowed more people to report relief. In his randomized controlled trial, he tried the combo on 56 patients with diabetic neuropathy or postherpetic neuralgia (the chronic pain from shingles). All the patients reported their daily pain as at least a 4 on a scale of 0 to 10.

There were three daily treatment plans: gabapentin, nortriptyline, or their combination. All patients got to try all three treatments over three 6-week periods. Overall, more people reported good pain relief when the drugs were combined:

• 64 per cent reported moderate to complete relief with gabapentin
• 75 per cent reported moderate to complete relief with nortriptyline
• 81 per cent reported moderate to complete relief with the combination.

There were few side effects from the combination, though some complained of dry mouth.

Debbie Loder was one of those who got relief, and for her, that meant she could finally get some sleep.

"The combination of pills worked, very, very well," she reports.

Dr. Jane Aubin, Scientific Director of CIHR's Institute of Musculoskeletal Health and Arthritis, says the findings are an interesting and important result.

"Many chronic pain sufferers don't sleep well, and they get caught in a vicious cycle in which less sleep equals more pain. Dr. Gilron's work offers new hope to Canadians desperate to put an end to this debilitating situation," she said in a statement.

Doctors suspect the drug combination might also be used to treat other forms of chronic pain, from arthritis, back injuries, even pain from cancer therapy. Researchers are now planning more studies of other combinations of drugs that may ease pain better together, than they ever did on their own.

With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip