Memantine and Tiagabine

Two drugs typically used in the treatment of neurologic disease, memantine and tiagabine, show potential in 2 different pain settings — migraine and fibromyalgia, respectively. In the first study, Sorensen and Jenson explored memantine, which is approved for the treatment of Alzheimer’s disease, as a prophylactic agent for reducing the frequency of migraine. The 18 patients in the study had been refractory to a variety of other prophylactic agents and acute migraine therapies. However, 11 of the patients described their results as excellent and 4 as good. Sorensen also investigated the anticonvulsant tiagabine as a treatment for primary fibromyalgia syndrome. The short-form of the McGill Pain Questionnaire was used. Again, the 11 patients had not responded to a variety of standard treatments, including opiates, NSAIDs, tricyclic antidepressants, and another anticonvulsant — gabapentin. In this case, 6 patients reported an excellent result and 1 reported a good result, again with the McGill short form. One patient discontinued due to nausea and sedation, and 1 patient withdrew due to a poor response. Dr. Sorensen stressed that further investigation would be necessary with both therapies, although the initial results are promising.

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