title: Memantine for Prophylactic Treatment of Migraine Without Aura: A Randomized Double-Blind Placebo-Controlled Study.
abstract: BACKGROUND
  Uncontrolled studies in human have suggested that memantine might be a suitable option for migraine prophylaxis.
  
  
  OBJECTIVE
  To assess the efficacy and tolerability of memantine for migraine prophylaxis.
  
  
  METHODS
  This was a 12-week randomized double-blind placebo-controlled parallel-group study. Sixty patients with migraine without aura were randomized using a computer-generated list to receive memantine (10 mg/day) or placebo for 12 weeks. The primary outcome was the difference in change from baseline in the monthly attack frequency at week 12 between the two groups (using migraine diary). Secondary efficacy measures were assessed using several clinical, functional, and psychological instruments. We performed both complete case (CC) and intention-to-treat analyses (ITT).
  
  
  RESULTS
  Twenty-five patients in the memantine group and 27 patients in the placebo group completed the study. Patients in the memantine group showed significantly greater reduction (mean change; 3.4; 95%CI, 2.3-4.4) in the monthly attack frequency than the placebo group (mean change, 1.0; 95%CI, 0.3-1.7) (mean difference [MD], 2.3; 95%CI, 1.1-3.5, P < .001). Both CC (MD, 4.9; 95%CI, 2.6-7.2 days), and ITT analyses (MD, 5.2; 95%CI, 2.0-8.5) showed significantly higher reduction in the mean number of migraine days in the memantine group than the placebo group (P < .01). Patients in the memantine group experienced greater reduction in the number of work absence days, severity, and disability score than the patients in the placebo group in both ITT and CC analyses. Changes in quality of life, sleep, depression, and anxiety did not differ between the two groups. Three patients in the memantine group complained of sedation, mild vertigo and nausea, and drowsiness. In the placebo group, one patient complained of nausea and another patient discontinued treatment after 2 weeks due to vertigo.
  
  
  CONCLUSIONS
  Memantine might be a tolerable and efficacious option for prophylaxis in patients with migraine without aura. Tolerability, short duration required for titration, and safety profile in pregnancy might give memantine an advantage over other antimigraine medications. The study was registered in the Iranian Registry of Clinical Trials (Registration number: IRCT2013120115616N1).
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Rezvan
authors.initials: R
authors.lastname: Noruzzadeh
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Modabbernia
authors.affiliation: Neurology Department, Roozbeh Hospital, Tehran University of Medical Sciences.
authors.forename: Vajiheh
authors.initials: V
authors.lastname: Aghamollaii
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Ghaffarpour
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Harirchian
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sarvenaz
authors.initials: S
authors.lastname: Salahi
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nikta
authors.initials: N
authors.lastname: Nikbakht
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Noruzi
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Tafakhori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D008875:Middle Aged; D020326:Migraine without Aura / Q000517:prevention & control*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018691:Excitatory Amino Acid Antagonists; D008559:Memantine
keywords: glutamate; memantine; migraine without aura; placebo; prophylaxis; randomized controlled trial