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However, up to 40% of patients do not achieve satisfactory relief, prompting investigation of combination therapy, most commonly adding a second agent (e.g., duloxetine plus pregabalin), which can yield incremental pain reduction of 1020% but with increased risk of sedation, dizziness and drug interactions [64]

Exploratory review on the effect of Astragalus mongholicus on signaling pathways

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This is done by stimulating the expression of two vitally important proteins, arylalkylamine-N-acetyltransferase (AANAT) and the transcriptional protein pCREB