Namenda (mémantine): Un nouveau traitement potentiel pour la fibromyalgie

Namenda (mémantine) est un bien établi, le traitement modéré à sévère la maladie d’ Alzheimer. Namenda agit pour réduire l’activité d’un ensemble de récepteurs dans le cerveau et la moelle épinière appelées récepteurs NMDA.
Surstimulation des récepteurs NMDA est censé contribuer à la sensibilité à la douleur accrue dans la fibromyalgie. Par conséquent, le traitement des patients atteints de fibromyalgie mémantine devrait, en théorie, réduire la douleur de la fibromyalgie.
Toutefois, au cours de la dernière décennie n’était prêt à investir les fonds nécessaires pour mettre cette théorie à l’ épreuve. Mais maintenant , cela a changé. Une équipe de recherche espagnole a fait un double très capable – étude aveugle. Résultats: Les patients atteints de fibromyalgie traités par mémantine avaient moins de douleur, l’ amélioration de la cognition et une meilleure performance de la journée, par rapport à un groupe témoin qui a pris un placebo.
Si ces résultats sont confirmés dans des études futures – comme toujours le problème du financement – mémantine pourrait rapidement devenir un traitement de choix de la fibromyalgie des piliers.
Cette recherche d’étude clé a été fait en Espagne. Les sujets qui ont rencontré l’American College of Rheumatology définition de cas pour la fibromyalgie 1990 ont été recrutés pour prendre soit mémantine ou un placebo.
Au cours du procès soumet six mois qui ont reçu la mémantine avait beaucoup moins de douleur, améliore la capacité cognitive, et l’ amélioration de la fonction quotidienne que les patients prenant un placebo. Une amélioration statistiquement significative a eu lieu dans les premiers mois et a persisté tout au long de l’épreuve a duré six mois.
Les effets secondaires de la mémantine ont tendance à être doux. Il y a relativement peu d’ interactions indésirables avec d’ autres médicaments. Par conséquent, si ces résultats encourageants sont confirmés par d’ autres études, Namenda (mémantine) pourrait rapidement devenir un traitement de soutien.
Dr Barbara Olivan-Blazquez, le Dr Javier García-Campayo et son équipe à l’Université de Saragosse a recruté 60 patients atteints de fibromyalgie long terme. La moitié a reçu la mémantine, les autres ont pris un placebo.
Ils ont mesuré l’état de la douleur de deux façons différentes. Tout d’ abord, ils ont utilisé une échelle visuelle analogique où le taux de perception du patient sa subjective de la douleur sur une échelle de zéro à 10. Zéro signifie aucune douleur. Dix est la pire douleur possible.
Après un mois de mémantine, le score moyen visuelle analogique a diminué de 6,56 à 4,83. Autrement dit, les patients traités par la mémantine ont rapporté moins de douleur. En revanche, les sujets prenant un placebo ont augmenté légèrement leur score de douleur de 6,48 à 6,64. La différence en faveur du groupe mémantine était très significative (P = 0,001). Des différences significatives en faveur du groupe mémantine ont continué tout au long de l’étude sur six mois.
Une deuxième façon de mesurer la douleur était de donner vie à un brassard de pression artérielle. Au départ, les sujets du groupe mémantine se sont plaints de la douleur lors de la lecture brassard de pression artérielle moyenne était de 97,9 millimètres de mercure (mmHg). Un mois plus tard, une pression artérielle moyenne de 112 mmHg est nécessaire. avant que la douleur a été observée. Par conséquent, la sensibilité à la douleur avait disparu. Les patients traités par placebo ont montré le contraire – une légère augmentation de la sensibilité au brassard de pression artérielle induite par la douleur.
Le degré d’amélioration de la douleur était modérée pour la plupart des patients traités par la mémantine, bien qu’il était dramatique dans certains pays . Seulement seize pour cent des sujets traités par mémantine réalise une amélioration de 50% de la douleur (5 31subjects). Cependant, aucun (0%) du groupe placebo – les sujets traités devaient grandement améliorer.
Les questions mémantine a également été significativement meilleure que le placebo pour l’état mental mini – examen de la fonction cognitive, sur une échelle de dépression et diverses mesures d’activité fonctionnelle. Le résultat final: Les sujets qui ont mémantine ont eu tendance à se sentir mieux tout en étant plus actif.
Est – il raisonnable qu’un médecin envisage d’ utiliser mémantine comme un traitement pour « off-label » pour la fibromyalgie? Nous avons une étude assez petite. Donc , nous ne pouvons pas dire avec certitude si la mémantine « fonctionne vraiment. » Mais en tant que médicaments vont, mémantine est considéré comme assez sûr. Parmi les patients atteints d’Alzheimer, les effets secondaires les plus fréquents sont des vertiges, des maux de tête, la confusion et la constipation. Peu d’ interactions médicamenteuses indésirables. Mais il faut éviter de mélanger antagoniste du récepteur de NMDA mémantine Drug tels que l’ amantadine, la kétamine et le dextrométhorphane (un antitussif à Delsym).
Des chercheurs espagnols ont commencé à traiter 5 mg une fois par jour. Il est apprécié pour un mois

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