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Alzheimer's Drug May Benefit Fibromyalgia Patients

  [ 21 votes ]   [ Discuss This Article ] • September 14, 2014

Editor's comment: The drug memantine has been approved by the FDA for the treatment of moderate to severe Alzheimer's disease. It acts on the glutamatergic system by blocking NMDA receptors. Because some studies have found elevated glutamate levels in several brain regions of fibromyalgia patients, Spanish researchers hypothesized that memantine may be beneficial for people with FM.

Efficacy of memantine in the treatment of fibromyalgia: a double-blind randomised controlled trial with 6-month follow-up.

By B. Olivan-Blázquez, et al.


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.

Source: Pain, September 10, 2014. By B. Olivan-Blázquez, P. Herrera-Mercadal, M. Puebla-Guedea, M.C. Pérez-Yus, E. Andrés, N. Fayed, Y.L. Hoyo, R. Magallon, M. Roca, J. Garcia-Campayo.

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