Other Preventive Anti-Migraine Treatments: ACE Inhibitors, ARBs, Calcium Channel Blockers, Serotonin Antagonists, and NMDA Receptor Antagonists

Rau, Jill C.; Dodick, David W.

doi:10.1007/s11940-019-0559-0

Cited by 22 publications

(17 citation statements)

References 105 publications

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“…Based on the latest guidelines, memantine has only Level C (weak) evidence for the prophylaxis of migraine since until recently, there was only one published RCT that had favorable results for memantine. 7,8 With recently available RCT that supports memantine use, thorough evaluation of evidence is recommended. 10 The study design inclusion criterion for this review was deliberately expanded to include non-randomized studies to generate a more comprehensive analysis due to the paucity of currently published RCTs.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Memantine is a voltage-dependent, non-competitive antagonist of the NMDA receptor that decreases glutaminergic activity, thus, possibly preventing migraine attacks. 6,7 Memantine offers key advantages over other drugs for migraine prophylaxis: minimal and more tolerable side effects, 7 shorter time required for titration to therapeutic levels, 7 relatively safe use in pregnancy (safety category B), 8 and more accessible versus novel antibodies approved for the prevention of episodic migraine. Memantine may be an ideal drug option for migraine prophylaxis due to its pharmacokinetics.…”

Section: Introductionmentioning

confidence: 99%

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Memantine for Episodic Migraine: A Systematic Review and Meta-analysis

Mondia

Espiritu²,

Bolaños³

et al. 2021

Acta Med Philipp

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Introduction. Migraine is a common, debilitating primary headache. Memantine is a non-competitive N-methyl D-aspartate (NMDA) antagonist that lowers neuronal excitability that could prevent migraine attacks. This study aimed to determine the efficacy and safety of memantine in patients with episodic migraine attacks using a systematic review and meta-analysis.Methods. We searched CENTRAL, MEDLINE, Scopus, Cochrane, LILACS, ClinicalTrials.gov, HERDIN and Google Scholar for relevant studies until July 31, 2020. Prespecified screening and eligibility criteria for inclusion were applied. Included studies underwent methodological quality assessment. Study design, patient characteristics, interventions given, and relevant outcomes were extracted and synthesized.Results. This review included five relevant articles -two randomized controlled trials (RCT) and three nonrandomized studies (one retrospective records review and survey, two prospective open-label single-arm trials). There were 109 patients included in the RCTs and 197 patients reported in the non-randomized studies. Pooled data from the two RCTs showed that memantine at 10 mg/day significantly decreased the monthly number of migraine days at 12 weeks compared to placebo with a mean difference of -1.58 [95% confidence interval (CI) -1.84, -1.32]. Non-randomized studies also showed a decrease in migraine days per month with memantine (5 to 20 mg/day) after 12 weeks [95%

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Memantine for Episodic Migraine: A Systematic Review and Meta-analysis

Mondia

Espiritu²,

Bolaños³

et al. 2021

Acta Med Philipp

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“…NSAIDs, such as acetaminophen, naproxen or ibuprofen, are recommended for the treatment of mild to moderate migraine. Migraine-specific drugs such as ergot and triptan are recommended for the treatment of moderate to severe headache, allowing for rapid symptomatic improvement (54,55). Since the condition of most migraine patients is constantly changing, it is difficult to ensure that the medication type and dosage prescribed to each patient included in the present study were consistent throughout the treatment phase.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine

Fan

Sun

et al. 2020

Front. Neurol.

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Background: Migraine is an intractable headache disorder, manifesting as periodic attacks. It is highly burdensome for patients and society. Acupuncture treatment can be beneficial as a supplementary and preventive therapy for migraine. Objectives: This systematic review and meta-analysis aimed to investigate the efficacy and safety of acupuncture for migraine, and to examine transcranial doppler changes after acupuncture. Methods: Reports, conference, and academic papers published before March 15, 2019 in databases including PubMed, Cochrane library, Embase, China National Knowledge Infrastructure, WANFANG Database, Chinese journal of Science and Technology, and China Biomedical were searched. Randomized controlled trials (RCTs) involving acupuncture, sham acupuncture, and medication in migraine were included. The Cochrane Collaboration software, RevMan 5.3, was used for data processing and migration risk analysis. Results: Twenty-eight RCTs were included. 15 RCTs included medication only, 10 RCTs included sham acupuncture only, and 3 RCTs included both. The study included 2874 patients, split into 3 groups: acupuncture treatment group (n = 1396), medication control group (n = 865), and sham acupuncture control group (n = 613). The results showed that treatment was more effective in the acupuncture group than in the sham acupuncture group (MD = 1.88, 95% CI [1.61, 2.20], P < 0.00001) and medication group (MD = 1.16, 95% CI [1.12, 1.21], P < 0.00001). Improvement in visual analog scale (VAS) score was greater in the acupuncture group than in the sham acupuncture group (MD = −1.00, 95% CI [-1.27,−0.46], P < 0.00001; MD = −0.59, 95% CI [-0.81,−0.38], P < 0.00001), and their adverse reaction rate was lower than that of the medication group (RR = 0.16, 95% CI [0.05, 0.52], P = 0.002). The improvement of intracranial blood flow velocity by acupuncture is better than that by medication, but the heterogeneity makes the result unreliable. Conclusions: Acupuncture reduced the frequency of migraine attacks, lowered VAS scores, and increased therapeutic efficiency compared with sham acupuncture. Ou et al. Meta-analysis of Acupuncture and Migraine Compared with medication, acupuncture showed higher effectiveness with less adverse reactions and improved intracranial blood circulation. However, owing to inter-study heterogeneity, a prospective, multicenter RCT with a large sample is required to verify these results.

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“…5 Additionally, because of variation of migraine characteristics between individuals, treatment plans should be based on patient preference, comorbidities, frequency and severity of episodes, contraindications, and concomitant medications. [5][6][7][8] Recently, there has been an emergence of research assessing novel mechanisms of new and existing medication therapies for migraine prophylaxis. The exact pathophysiology of migraine is not completely understood, although it is thought that there is a link between abnormal neuronal excitability and activation of the trigeminovascular complex.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…In women of childbearing potential, or who are currently pregnant, breastfeeding, or attempting to conceive, preventive treatment selection is especially limited as many preventive treatment options, such as valproic acid and topiramate, need to be discontinued due to risk of fetal harm 5 . Additionally, because of variation of migraine characteristics between individuals, treatment plans should be based on patient preference, comorbidities, frequency and severity of episodes, contraindications, and concomitant medications 5–8 …”

Section: Introductionmentioning

confidence: 99%

Role of memantine in the prophylactic treatment of episodic migraine: A systematic review

et al. 2021

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Objective The purpose of this systematic review is to assess the efficacy and safety of memantine for the prophylactic treatment of episodic migraine. Background Migraine is a prevalent chronic disease with significant costs to the health care system. Although various prophylactic treatment options are available, these medications have limitations based on efficacy, potential side effects, and patient preference. Memantine is an N‐methyl‐d‐aspartate receptor antagonist used in dementia treatment that may have potential benefit for migraine prophylaxis. Methods A systematic search of PubMed, Embase, and CENTRAL databases was conducted to identify relevant published studies through December 2020 using the search terms: migraine disorders, migraine, headache disorders, or headache and memantine. Studies selected for the systematic review included prospective, interventional designs and evaluated memantine for prophylaxis of migraine. Animal studies, case reports, abstracts, review articles, protocols without results, and studies not written in English were excluded. Data were extracted using a standardized systematic process and included author, publication date, study design, sample size, patient characteristics, treatment regimen, clinical efficacy outcomes, and adverse drug effects. Results Four articles were identified for inclusion representing two prospective open‐label studies and two randomized, double‐blind trials, evaluating 183 patients on memantine overall. A reduction in number of migraine days and headache severity were shown in all four studies in the participants treated with memantine. The most common adverse effects included somnolence, sedation, and nausea, none of which were severe. Conclusion The studies in this review establish that memantine has the potential for use as a treatment option for episodic migraine. Additional long‐term studies using an active comparator would be useful to further elucidate its role.

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Other Preventive Anti-Migraine Treatments: ACE Inhibitors, ARBs, Calcium Channel Blockers, Serotonin Antagonists, and NMDA Receptor Antagonists

Cited by 22 publications

References 105 publications

Memantine for Episodic Migraine: A Systematic Review and Meta-analysis

Memantine for Episodic Migraine: A Systematic Review and Meta-analysis

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine

Role of memantine in the prophylactic treatment of episodic migraine: A systematic review

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