The Alzheimer’s disease drug memantine may help reduce the frequency of migraines, say the authors of a study showing that memantine prophylaxis significantly reduced the incidence of migraines without aura.
Results of a randomized, double-blind, placebo-controlled trial in 52 patients who experienced two or more migraines without aura a month showed that those treated with 10 mg/day of memantine experienced at least two fewer migraines each month, compared with the placebo group (mean difference, 2.3; 95% confidence interval, 1.1-3.5).
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Treatment with the glutamate N-methyl-D-aspartate receptor antagonist was associated with an average 62% reduction in monthly attack frequency, compared with a 17% reduction in the placebo group, and a significantly greater reduction in the mean number of migraine days and headache severity, compared with placebo.
The study, published online Dec. 6 in Headache, also found greater reductions in Migraine Disability Assessment Scale (MIDAS) score in the memantine group; decreasing by at least two categories in 44% of patients on memantine, compared with 11% of patients on placebo.
Dr. Rezvan Noruzzadeh of the Tehran University of Medical Sciences and coauthors wrote that there is growing interest in the role of glutamate in migraine pathophysiology.
“Glutamate levels are elevated in cerebrospinal fluid of patients with chronic migraine, suggesting an excess of this neurotransmitter in the brains of patients,” the authors reported (Headache. 2015 Dec 6. doi: 10.1111/head.12732).
Memantine showed a favorable side effect profile, with three patients in the intervention arm and two patients in the placebo arm reporting sedation, mild vertigo, nausea, or drowsiness.
“Other prophylactic antimigraine agents are often associated with considerable side effects; [the] significant hair loss and weight gain of valproate are particularly undesirable for women, who are the main sufferers of migraine headaches,” the authors wrote.
They also pointed out that unlike other migraine prophylactic treatments, memantine is suitable for use in pregnancy.
The study was supported by the Tehran University of Medical Sciences. No conflicts of interest were declared.