Memantine is a drug typically used to treat people with Parkinson’s disease and Alzheimer’s disease, but a new study has found it can also help with pain relief in fibromyalgia, a condition that can be a cause of neck pain. Fibromyalgia is characterised by an increased sensitivity to pain, with specific tender points, in addition to fatigue and cognitive symptoms.
Why Treat Fibromyalgia with Memantine?
Memantine is a medication that can block glutamate, an excitatory neurotransmitter found at elevated levels in several regions of the brain in people with fibromyalgia. This latest study is the first to investigate the use of memantine for fibromyalgia treatment and the results suggest that it could be added to the range of medications already used by patients.
The study, published in the September issue of the journal Pain, offers good quality evidence as it is a randomised, controlled trial. However, the sample size was small and the follow-up period short; the study only involved 63 patients with fibromyalgia who were monitored over a 6-month treatment program. The trial was carried out by Bárbara Oliván-Blázquez and colleagues at the Department of Psychology and Sociology at the University of Zaragoza, Spain, and was not a multicentre study, demonstrating a need to replicate the findings with a larger, multicentre protocol with a longer assessment period.
Details of the Fibromyalgia Memantine Study
Oliván-Blázquez randomised patients to either a group receiving a placebo pill each day for 6 months, or a group receiving 20mg of memantine daily. All patients already undergoing fibromyalgia treatment had a 1-week washout period before the study commenced and the researchers noted that at the start of the study the placebo and memantine groups had similar characteristics in terms of pain and quality of life, as assessed using the Fibromyalgia Impact Questionnaire, a pain visual analog scale, and a sphygmomanometer (a device to measure pain tolerance).
Fibromyalgia Relief from Memantine
Evaluations were made after 1 month, 3 months, and 6 months of therapy and memantine was found to increase the patients’ pain threshold, decrease pain perception, and to improve depression, cognitive state and quality of life. The decrease in pain and improved pain tolerance were significant at 6 months, with the number needed to treat 6.2, and the relative risk reduction 16.13%.
Memantine Side Effects
Memantine’s side effects were not found to be any worse than for existing medications used to treat fibromyalgia. A quarter (8 people, 25.8%) of the patients taking memantine reported dizziness, compared to 12.5% of those taking placebo. Other side effects included headache, which occurred in 12.9% (4) of the memantine group and 15.6% of the placebo group. In general, memantine is well tolerated and considered very safe for use in people with dementia and other conditions. The side effects are usually temporary and mild, and symptoms of withdrawal from memantine are uncommon.
People with fibromyalgia are often treated with antidepressants and pain killers, with drugs aiming to decrease pain sensitivity and elevate levels of serotonin, an important neurotransmitter that is often found to be low in people with fibromyalgia. Duloxetine and pregabalin are two of the most commonly used medications for managing fibromyalgia, and memantine may become a useful adjunct treatment in helping relieve symptoms of fibromyalgia, such as neck pain.
Olivan-Blázquez B, Herrera-Mercadal P, Puebla-Guedea M, Pérez-Yus MC, Andrés E, Fayed N, López-Del-Hoyo Y, Magallon R, Roca M, Garcia-Campayo J. (2014).
Efficacy of memantine in the treatment of fibromyalgia: A double-blind, randomised, controlled trial with 6-month follow-up. Pain. 2014 Sep 16. pii: S0304-3959(14)00424-2.