Namenda (memantina): Um potencial novo tratamento para fibromialgia

Namenda (memantina) é um bem estabelecido, o tratamento para moderada a grave doença de Alzheimer. Namenda actua de modo a reduzir a actividade de um conjunto de receptores no cérebro e medula espinhal chamados receptores de NMDA.
Acredita-se que sobre-estimulação dos receptores de NMDA para contribuir para o aumento da sensibilidade à dor na fibromialgia. Portanto, o tratamento de pacientes com fibromialgia memantina deveria, em teoria, reduzir a dor de fibromialgia.
No entanto, na última década, ninguém estava disposto a investir os fundos necessários para colocar esta teoria para o teste. Mas agora isso mudou. Uma equipa de investigação espanhol fez uma dupla muito capaz – estudo cego. Resultados: Os pacientes com fibromialgia tratados com memantina tiveram menos dor, melhor cognição e melhor desempenho do dia, em comparação com um grupo controle que tomaram um placebo.
Se estes resultados forem confirmados em estudos futuros – como sempre o problema do financiamento – memantina poderia rapidamente tornar-se um tratamento de escolha fibromialgia dos pilares.
Esta pesquisa chave estudo foi feito em Espanha. Sujeitos que atenderam o American College of Rheumatology 1990 definição de caso para a fibromialgia foram recrutados para tomar uma memantina ou um placebo.
Durante o julgamento submete seis meses que receberam memantina tiveram significativamente menos dor, melhora a capacidade cognitiva, e melhorou a função diária do que os pacientes que tomam um placebo. Uma melhoria estatisticamente significativa ocorreu nos primeiros meses e persistiu durante todo o teste longo de seis meses.
Os efeitos colaterais de memantina tendem a ser suaves. Há relativamente poucas interacções adversas com outros fármacos. Portanto, se estes resultados encorajadores são confirmados por outros estudos, Namenda (memantina) poderia rapidamente tornar-se um tratamento de suporte.
Dr. Barbara Olivan-Blazquez, Dr. Javier García-Campayo e sua equipe na Universidade de Zaragoza recrutados 60 pacientes com fibromialgia longo prazo. Metade recebeu a memantina, os outros tomaram um placebo.
Eles mediram o estado de dor de duas maneiras diferentes. Primeiro, eles usaram uma escala visual analógica onde a taxa de paciente sua percepção subjetiva de dor em uma escala de zero a 10. Zero significa nenhuma dor. Dez é a pior dor possível.
Após um mês de memantina, contagem média visual analógica diminuiu 6,56-4,83. Ou seja, os pacientes tratados com memantina relataram menos dor. Em contraste, indivíduos que tomaram placebo aumentou modestamente a sua pontuação de dor 6,48-6,64. A diferença a favor do grupo de memantina foi altamente significativa (P = 0,001). diferenças significativas em favor do grupo de memantina continuou ao longo do estudo ao longo de seis meses.
Uma segunda maneira de medir a dor era dar vida para uma manga de pressão arterial. No início do estudo, os sujeitos no grupo de memantina queixou de dor durante a leitura manguito pressão arterial média foi de 97,9 milímetros de mercúrio (mmHg). Um mês mais tarde, uma pressão arterial média de 112 mmHg é necessária. antes foi observada dor. Por isso, a sensibilidade à dor tinha diminuído. Os doentes tratados com placebo mostrou o oposto – um ligeiro aumento na sensibilidade à dor induzida braçadeira de pressão sanguínea.
O grau de melhoria de dor foi moderada para a maioria dos pacientes tratados com memantina, embora foi dramático em alguns. Apenas dezasseis por cento dos pacientes tratados com memantina consegue uma melhoria de 50% da dor (5 31subjects). No entanto, nenhum (0%) de placebo – tratada indivíduos tinham que melhorar muito.
Questões memantina também foi significativamente melhor do que placebo para o mini-exame do estado mental da função cognitiva, em uma escala de depressão e várias medidas de atividade funcional. O resultado final: indivíduos que tomaram memantina tendem a se sentir melhor enquanto ser mais ativo.
É razoável que um médico considerar o uso de memantina como um tratamento para “off-label” para a fibromialgia? Temos um pequeno estudo suficiente. Portanto, não podemos dizer com certeza se a memantina “realmente funciona.” Mas como drogas ir, a memantina é considerado bastante seguro. Entre os pacientes com Alzheimer, os efeitos colaterais mais comuns são tontura, dor de cabeça, confusão e constipação. Poucas interacções medicamentosas adversas. Mas deve-se evitar a mistura de memantina, antagonista do receptor de NMDA de Drogas tais como a amantadina, a cetamina e dextrometorfano (um supressor da tosse em Delsym).
Pesquisadores espanhóis começaram a tratar 5 mg uma vez por dia. É valorizado por um mês para

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