Memantine for Fibromyalgia: Results from First Randomized, Controlled Study

the MPR take:

It is suspected that glutamate (Glu), an excitatory CNS neurotransmitter, may have a role in the pathophysiology of fibromyalgia; memantine, an N-methyl-D-aspartate (NMDA) receptor antagonist, could assist in reducing glutamate’s neurotoxic effect by preventing the entry of excess calcium. A study in the journal Pain outlines a double-blind, multi-center, parallel randomized clinical trial on 63 patients ages 18–65 with a confirmed diagnosis of fibromyalgia who were given either memantine 20mg daily for six months (after a one month titration period) or placebo. Patients were evaluated at baseline, post-treatment (including one month of titration), and 3- and 6-months post-treatment. The memantine group experienced significantly decreased ratings on the pain visual analogue scale (Cohen’s d=1.43 at six months) and pain measured with a sphygmomanometer (d=1.05) compared to the placebo group. With the exception of anxiety, a moderate-to-large effect size was seen on all secondary outcome measurements (global function, clinical global impression, quality of life, depression, and cognitive function at six months). As this is the first randomized, controlled study on memantine for the treatment of fibromyalgia, additional research with larger samples and longer follow-ups are needed but the findings are promising for an alternative to existing therapies.

Memantine has shown efficacy in the treatment of pain and other clinical variables (depression, anxiety, quality of life, function, clinical impression) in patients with fibromyalgia.

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