Namenda (memantina): Un nuevo tratamiento potencial para la fibromialgia

Namenda (memantina) es una bien establecida, el tratamiento para la enfermedad moderada a severa de Alzheimer. Namenda actúa para reducir la actividad de un conjunto de receptores en el cerebro y la médula espinal llamado receptores de NMDA .
La sobreestimulación de los receptores NMDA se cree que contribuye al aumento de la sensibilidad al dolor en la fibromialgia. Por lo tanto, el tratamiento de pacientes con fibromialgia con memantina debería, en teoría, disminuir el dolor de fibromialgia.
Sin embargo, durante la última década nadie estaba dispuesto a invertir los fondos necesarios para poner esta teoría a prueba. Pero, ahora que ha cambiado. Un equipo de investigación español muy capaz ha hecho un estudio doble ciego. Los resultados: Los pacientes con fibromialgia tratados con memantina tuvieron menos dolor, mejor cognición y un mejor funcionamiento del día a día, en comparación con un grupo control, que tomaron un placebo.
Si estos resultados se confirman en estudios futuros – como siempre el problema de la financiación – memantina podría convertirse rápidamente en un tratamiento de la fibromialgia elección de los pilares.
Este estudio clave investigación se hizo en España. Los sujetos que cumplían el Colegio Americano de Reumatología 1990 definición de caso para la fibromialgia fueron reclutados para tomar ya la memantina o un placebo.
Durante los sujetos del ensayo de seis meses que recibieron memantina tuvieron considerablemente menos dolor, mejora la capacidad cognitiva, y una mejor función del día a día que los pacientes que tomaban un placebo. Una mejoría estadísticamente significativa se produjo en el primer mes y persistió durante todo el ensayo a largo seis meses.
Los efectos secundarios de memantina tienden a ser leves. Hay relativamente pocas interacciones adversas con otros fármacos. Por lo tanto, si estos alentadores resultados son confirmados por otros estudios, Namenda (memantina) podría convertirse rápidamente en un tratamiento de sostén.
Dr. Barbara Olivan-Blázquez, el Dr. Javier García-Campayo y su equipo de la Universidad de Zaragoza reclutó a unos 60 pacientes con fibromialgia a largo plazo. La mitad recibió memantina, los otros tomaron un placebo.
Midieron el estado de dolor de dos maneras diferentes. En primer lugar, utilizaron una escala analógica visual donde la tasa de paciente su percepción subjetiva del dolor en una escala de cero a 10. Cero significa que no hay dolor. Diez es el peor dolor posible.
Después de un mes de la memantina, la puntuación media analógica visual disminuyó desde 6,56 hasta 4,83. Es decir, los pacientes tratados con memantina reportaron menos dolor. Por el contrario, los sujetos que tomaron placebo modestamente aumentaron su puntuación de dolor 6,48-6,64. La diferencia a favor del grupo memantina fue altamente significativa (P = 0,001). Diferencias significativas a favor del grupo tratado con memantina continuaron durante todo el estudio a largo de seis meses.
Una segunda manera de medir el dolor era para darle vida a un manguito de presión arterial. Al inicio del estudio, los sujetos del grupo de memantina se quejaron de dolor cuando la lectura promedio manguito de presión arterial fue del 97,9 milímetros de mercurio (mmHg). Un mes más tarde, se requiere una presión arterial media de 112 mmHg. antes de que se observó dolor. Por lo tanto, la sensibilidad al dolor había disminuido. Los pacientes tratados con el placebo mostraron lo contrario – un leve aumento de su sensibilidad al dolor inducido manguito de presión arterial.
El grado de mejoría del dolor fue moderado para la mayoría de pacientes tratados con memantina, aunque fue dramático en algunos. Sólo dieciséis por ciento de los sujetos tratados con memantina logra una mejora del 50% en el dolor (5 de 31subjects). Sin embargo, ninguno (0%) de los sujetos tratados con placebo tenía que mejorar mucho.
Temas sobre la memantina también fue significativamente mejor que los de placebo para el mini examen del estado mental de la función cognitiva, en una escala de depresión y en varias medidas de la actividad funcional. El resultado final: Los sujetos que tomaron memantina tendía a sentirse mejor al mismo tiempo ser más activo.
¿Es razonable que un médico considere el uso de memantina como tratamiento “fuera de etiqueta” para la fibromialgia? Tenemos un solo bastante pequeño estudio. Así que no podemos decir con certeza si la memantina “realmente funciona.” Pero, como medicamentos van, la memantina se considera que es bastante seguro. Entre los pacientes de Alzheimer, los efectos secundarios más comunes son mareos, dolor de cabeza, confusión y estreñimiento. Interacciones farmacológicas adversas son pocos. Pero uno debe evitar la mezcla de memantina con otros medicamentos antagonista del receptor de NMDA, tales como amantadina, ketamina y dextrometorfano (el supresor de la tos en Delsym).
Los investigadores españoles comenzaron a tratar a los 5 mg una vez al día. Se valora durante un mes para un

168 thoughts on “Namenda (memantina): Un nuevo tratamiento potencial para la fibromialgia

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