Conclusion

NMDA antagonists in general and D-cycloserine (DCS) in specific have demonstrated extensive promise in the laboratory for the treatment of chronic pain and early promise in a clinical trial. Similarly, 5-HT2A antagonists show promise in the treatment of chronic pain. However, the well-known psychotogenic side effects of NMDA drugs and the potential for akathisia associated with chronic 5-HT2A antagonist drugs have limited their respective use in patients with chronic pain. The combined administration of DCS and lurasidone has been demonstrated in psychiatry-focused clinical trials to be nontoxic and the psychotogenic side effects of DCS appear to be blocked by lurasidone. The extensive body of nonclinical evidence combined with early clinical evidence supports the advancement of this drug combination to broader clinical study.