Prophylactic
migraine treatment has always been a challenge. Efficacy and tolerability are two main issues in current approved
migraine prevention regimens. Since some
migraine patients fail approved preventative agents, experts are always seeking newer agents.
Memantine, a glutaminergic antagonist, could potentially be one of these agents. Objective of current study is assessing the efficacy of
memantine as a preventative
migraine treatment and its potential side effects. In this study, 127
migraine patients meeting the criteria for starting preventative
therapy (> 4
headache days/month) are included in the study. All patients were previously failed in at least one trial of adequate preventive
therapy. After a 30 day baseline observation, patients started
memantine for 3 months, beginning at 5 mg/day, which increased by 5 mg/week up to a maximum of 20 mg a day if symptoms did not improve.
Headache frequency, duration, and severity were assessed at the end of the treatment phase. 102 patients completed the study. In the study population,
headache frequency reduced from 9.9 days/month at baseline to 5 days/month at 3 months (P < .001). The mean severe
pain reduced from 6.9 to 3.6 at 3 months (P < .001).
Headache duration significantly reduced at 3 months, compared with baseline (P < .001). Side effects related to
memantine consumption were uncommon and generally mild. Based on preliminary data, there is some evidence that
memantine might be useful in the treatment of refractory
migraine. This is in line with previous pilot and open label studies. However, double blind studies are still needed.