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National Migraine Centre
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combination treatment / combination therapy for migraines?

Hi. I came across a research paper in "Anaesthesia, Pain and Intensive Care" for combination therapy for trigeminal neuralgia (dated 2015 so fairly recent) "A restrospective review of combination therapy with pregabalin and carbamazepine versus pregabalin and amitriptyline in treatment of trigeminal neuralgia". This concluded that "a desirable reduction in pain could be achieved by lower dosages of PGB and CBZ. This finding provisionally confirms that combination approaches like this can prevent adverse side effects of high dose monotherapies, but requires prospective data collection".

Has anyone else come across combination therapy for chronic migraine? It strikes me that this is a fairly common-sense idea? Virtually all my migraine treatment has been monotherapy? The only reason I have have pregabalin and other treatments is because my GP isn't 100% sure whether I have chronic migraine and neuropathic pain.

As long as the interaction of the drug combinations is beneficial and not detrimental, then surely this is a good line of approach?! It could potentially radically increase the possible permutations available and therefore potential solutions to chronic migraine pain and symptoms.

2 Replies

important to look at levels of B12 mdedge.com/neurologyreviews...

I had low B12, plus my migraines were due to Hughes Syndrome/APS

Mary F


I was on gabapentin, pregablin and amitriptyline at the same time. Didn't make a huge difference to my migraines but did help my anxiety. I had a lot of weight gain that was blamed on the pregablin. Doctors didn't like me being on the combination because of the cost. Eventually I was taken off both pregablin and gabapentin and was given amitriptyline and botox instead which proved much more effective and lost weight too.

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