AUA 2009: Memantine
Posted: Tue Apr 07, 2009 12:56 am
(Note: this is an abstract from a conference, not a published study.)
Memantine in the Alleviation of Symptoms of Chronic Pelvic Pain Syndrome: A Randomized, Double-Blind Placebo-Controlled Trial
Authors: Jordan D Dimitrakov*, Boston, MA; Jean Chitalov, Ivan Dechev, Plovdiv, Bulgaria
Introduction and Objective: The etiology and underlying pathogenetic mechanisms of chronic pelvic pain syndrome (CPPS) remain elusive. The hallmark of the syndrome is chronic pelvic pain in the absence of identifiable underlying pathology. Recently, CPPS has been conceptualized as a central pain syndrome and N-methyl-D-aspartate (NMDA)-receptor mechanisms have been implicated in the generation of symptoms of CPPS. The objective of this study was to evaluate the efficacy and safety of memantine, a noncompetitive N-methyl-D-aspartate (NMDA)-receptor blocker in the alleviation of CPPS symptoms. Methods: 170 men with CPPS were randomly assigned to receive either memantine 20 mg/day or placebo for 1 year. CPPS was diagnosed in accordance with the CPCRN criteria. All patients provided written informed consent and the study was approved by the insitutional review board. The primary outcome was alleviation of pain at 6 months based on the NIH-CPSI pain domain scale. Secondary outcomes were patient-reported improvement in GRA, voiding and quality of life scales of the NIH-CPSI. Results: The study is ongoing and 1-year results will be presented at the AUA meeting. At 6 months, patients in the memantine group reported significant improvement in pain, GRA and quality of life as compared with patients in the placebo group (77% vs. 16%, P<0.001). No difference was noted between the placebo and treatment groups in the voiding subscale of the NIH-CPSI. Side effects were minimal and included dizziness (7%), headache (5%) and tiredness (1%). Conclusions: Memantine appears safe and effective in the alleviation of symptoms of chronic pelvic pan syndrome in men. Future studies should evaluate long-term treatment outcomes in larger patient cohorts.
Memantine in the Alleviation of Symptoms of Chronic Pelvic Pain Syndrome: A Randomized, Double-Blind Placebo-Controlled Trial
Authors: Jordan D Dimitrakov*, Boston, MA; Jean Chitalov, Ivan Dechev, Plovdiv, Bulgaria
Introduction and Objective: The etiology and underlying pathogenetic mechanisms of chronic pelvic pain syndrome (CPPS) remain elusive. The hallmark of the syndrome is chronic pelvic pain in the absence of identifiable underlying pathology. Recently, CPPS has been conceptualized as a central pain syndrome and N-methyl-D-aspartate (NMDA)-receptor mechanisms have been implicated in the generation of symptoms of CPPS. The objective of this study was to evaluate the efficacy and safety of memantine, a noncompetitive N-methyl-D-aspartate (NMDA)-receptor blocker in the alleviation of CPPS symptoms. Methods: 170 men with CPPS were randomly assigned to receive either memantine 20 mg/day or placebo for 1 year. CPPS was diagnosed in accordance with the CPCRN criteria. All patients provided written informed consent and the study was approved by the insitutional review board. The primary outcome was alleviation of pain at 6 months based on the NIH-CPSI pain domain scale. Secondary outcomes were patient-reported improvement in GRA, voiding and quality of life scales of the NIH-CPSI. Results: The study is ongoing and 1-year results will be presented at the AUA meeting. At 6 months, patients in the memantine group reported significant improvement in pain, GRA and quality of life as compared with patients in the placebo group (77% vs. 16%, P<0.001). No difference was noted between the placebo and treatment groups in the voiding subscale of the NIH-CPSI. Side effects were minimal and included dizziness (7%), headache (5%) and tiredness (1%). Conclusions: Memantine appears safe and effective in the alleviation of symptoms of chronic pelvic pan syndrome in men. Future studies should evaluate long-term treatment outcomes in larger patient cohorts.
