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Efficacy of memantine in the treatment of fibromyalgia

Discussion in 'Other Health News and Research' started by Ecoclimber, Sep 17, 2014.

  1. Ecoclimber

    Ecoclimber Senior Member

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    Pain. 2014 Sep 10. pii: S0304-3959(14)00424-2. doi: 10.1016/j.pain.2014.09.004. [Epub ahead of print]
    Efficacy of memantine in the treatment of fibromyalgia: a double-blind randomised controlled trial with 6-month follow-up.
    Olivan-Blázquez B1, Herrera-Mercadal P2, Puebla-Guedea M2, Pérez-Yus MC2, Andrés E3, Fayed N4, Hoyo YL5, Magallon R6, Roca M7, Garcia-Campayo J8.
    Author information

    Abstract

    Fibromyalgia (FM) is a prevalent and disabling chronic disease. Recent studies have found elevated levels of glutamate in several brain regions, leading to hypotheses about the usefulness of glutamate blocking drugs such as memantine in the treatment of FM.

    The aim of this study is to evaluate the efficacy of memantine in the treatment of pain and other clinical variables (global function, clinical impression, depression, anxiety, quality of life) in FM patients.

    Trial Design:

    A double-blind parallel randomised controlled trial was developed. A total of 63 patients diagnosed with FM were recruited from primary health care centres in Zaragoza, Spain. Memantine was administered at doses of 20 mg/day after one month of titration.

    Assessments were carried out at baseline, post-treatment, and 3- and 6-month follow-ups. Compared with a placebo group, memantine significantly decreased ratings on a pain visual analogue scale (Cohen's d=1.43 at 6 months) and pain measured with a sphygmomanometer (d=1.05).

    All other secondary outcomes except anxiety also improved, with moderate-to-large effect sizes at 6 months. Compared to placebo, the absolute risk reduction obtained with memantine was 16.13% (95% CI=2.0-32.6%), and the number needed to treat (NNT) was 6.2 (95% CI=3-47).

    Tolerance was good, with dizziness (8 patients) and headache (4 patients) being the most frequent side effects of memantine.

    Although additional studies with larger samples and longer follow-ups are needed, this study provides preliminary evidence of the utility of memantine for the treatment of FM.

    Copyright © 2014. Published by Elsevier B.V.

    KEYWORDS:
    Chronic pain; Fibromyalgia; Memantine; Randomised controlled trial
     
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  2. adreno

    adreno PR activist

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    It made me so brain fogged on 5mg that I could hardly remember my own name. Too strong for my taste. However I do like some natural NMDA antagonists like NAC, l-theanine and magnesium threonate.
     
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  3. Kati

    Kati Patient in training

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    barbc56, Bob, Marco and 2 others like this.
  4. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I have used it in low doses like 5mg. I found it had a calm but slightly energizing effects although the first day or 2 i did get a mild headache from it.

    nmda antagonist effects can help reduce benzo tolerance which i have found it helps .

    I recall it also has anti inflammatory effects through lower tnf alpha another inflammatory cytokine known to be high in many mecfsers
     
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  5. halcyon

    halcyon Senior Member

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    It also has antiviral effects on a number of viruses.
     
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  6. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Interesting, which viruses ?
     
  7. halcyon

    halcyon Senior Member

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    Here's a paper on effects on coronavirus. I'm not sure there's been much work on memantine, but amantadine has been shown to work against influenza and enteroviruses and I believe they would have the same mechanism of action as they are similar drugs. Rimantadine has similar antiviral effects.
     
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  8. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Cool.
    i had a quick google to see if it has antiviral effects on herpes viruses , i couldn't find anything concrete but it seems possible .
     
  9. leokitten

    leokitten Senior Member

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    Maryland
  10. Bob

    Bob

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  11. Deltrus

    Deltrus Senior Member

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    Did you take into account that memantine has an 80 hour half life? If you dose daily then 5mg turns into ~10-15mg after a few days. Better to dose low (1-2mg) for a couple days then slowly go up, in order to account for the long half life. Glutamate activation has an inverted U curve in effectiveness, so you can overshoot that very quickly and enter brain fog mode.
     
  12. minkeygirl

    minkeygirl But I Look So Good.

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    A really low dose even one day had me totally drugged out. I couldn't do it.
     
  13. Kati

    Kati Patient in training

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    Who prescribed it to you @minkeygirl ? Regular gp?
     
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  14. barbc56

    barbc56 Senior Member

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    Bump.

    I just read an article about this medication and it does sound promising. I'm intrigued
    as it's also used for Parkinson and some with RLS take anti Parkinsons medication.

    Any updates?

    Barb
     
  15. heyitisjustin

    heyitisjustin Senior Member

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    It sounds like NAC is an NMDA agonist (http://www.longecity.org/forum/topic/55624-does-anyone-have-experience-with-nac/) from my quick search. Do you have the source from where you learned NAC was an NMDA antagonist?
     
  16. adreno

    adreno PR activist

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    It may not act as an NMDA antagonist in the traditional sense. But it reduces glutaminergic neurotransmission:

    http://journal.frontiersin.org/article/10.3389/fnbeh.2015.00343/full
     
    Last edited: Sep 21, 2017
    Valentijn likes this.
  17. heyitisjustin

    heyitisjustin Senior Member

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