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Pregabalin + duloxetine is a combination therapy being investigated for the prevention and management of post-mastectomy pain syndrome (PMPS). This combination utilizes pregabalin, a gabapentinoid that modulates the alpha-2-delta subunit of voltage-gated calcium channels to reduce the release of excitatory neurotransmitters, and duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI) that enhances descending inhibitory pain pathways in the central nervous system. The study conducted by Cairo University evaluates the additive effect of these two agents when administered perioperatively to patients undergoing modified radical mastectomy, aiming to reduce the incidence and severity of chronic neuropathic pain following breast cancer surgery. By targeting multiple mechanisms of neuropathic pain, the combination seeks to provide superior analgesia compared to monotherapy.
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