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Gabapentin + donepezil is a combination of two small molecule drugs used experimentally for the management of neuropathic pain, particularly in patients who have an inadequate response to gabapentin monotherapy. Gabapentin is primarily an anticonvulsant that modulates voltage-gated calcium channels to reduce neuronal excitability and neurotransmitter release. Donepezil is an acetylcholinesterase inhibitor that increases synaptic acetylcholine levels by inhibiting its breakdown, commonly used in Alzheimer's disease. The combination has shown synergistic effects in preclinical models and early clinical studies, with evidence suggesting enhanced analgesia compared to gabapentin alone. This approach may allow for improved pain control at lower doses or with fewer side effects than higher-dose monotherapy[1][2][5].
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