Memantine for migraines

Memantine is an old medication which has been available in Europe for over 30 years, but was only recently introduced in this country for the treatment of Alzheimer’s disease.  Memantine blocks a specific receptor in the brain cells.  Activation of this so called NMDA receptor is responsible for many negative effects, including pain and nerve cell damage.  As soon as the drug was introduced in the US pain and headache specialists tried using it for pain, but probably because it is a weak blocker of the NMDA receptor our experience with this drug has not been very impressive.  However, in the recent issue of journal Headache Greek doctors report that one patient with chronic migraines obtained complete relief due to memantine.  One case report clearly does not prove that memantine is going to work for any significant percentage of patients.  However, this drug has relatively few side effects and if the usual treatments fail it may be worth trying.