Neuropathic pain is common in the palliative care population; unless adequately treated, the pain can lead to chronic anxiety, depression, and social impairment. Many treatments have been proposed for neuropathic pain; however, it remains underdiagnosed, under-treated, and often requires long-term therapy with risk of adverse effects. Memantine (Namenda), an N-Methyl, D-aspartate receptor inhibitor currently marketed for the treatment of dementia, has been proposed as a medication for the treatment of neuropathic pain for its mechanism, safety, lack of serious adverse effects, and relatively rapid onset of action. However, clinical trials have not been promising so far and its routine use in neuropathic pain is not currently recommended.
Wallace MSDiagnosis and treatment of neuropathic pain. Curr Opin Anaesthesiol . 2005;18:548-554.
2.
Nikolajsen L. , Gottrup H., Kristensen A., Jensen T.Memantine (an N-methyl-D-aspartate receptor antagonist) in the treatment of neuropathic pain after amputation or surgery: a randomized, double-blinded, cross-over study. Anesth Analog . 2000;91:960-966.
3.
In: Taylor RB, David AK, Johnson TA, Phillips DM, Scherger JE, eds. Family Medicine: Principles and Practice. 5th ed. New York, NY: Springer Publishing Co ; 1998.
4.
Fauci AS, Braunwald E., Kasper DL, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw-Hill Professional; 2008.
5.
Sang CN, Booher S., Gilron I., Parada S., Max MBDextromethorphan and memantine in painful diabetic neuropthy and postherpatic neuralgia. Anestheology. 2002;96:1053-1061.
6.
Forst T., Smith T., Schutte K., Marcus P., Pfützner A.; CNS 5161 Study Group. Dose escalating safety study of CNS 5161 HCl, a new neuronal glutamate receptor antagonist (NMDA) for the treatment of neuropathic pain. Br J Clin Pharmacol. 2007;64:75-82.
7.
Bennett GJUpdate on the neurophysiology of pain transmission and modulation: focus on the NMDAreceptor. J Pain Symptom Manage. 2000 ;19:S2-S6.
8.
Galer BSNeuropathic pain of peripheral origin: advances in pharmacologic treatment . Neurology. 1995;45:S17-S25.
9.
Schifitto G. , Yiannoutsos CT, Simpson DM, et al. A placebo-controlled study of memantine for the treatment of human immunodeficiency virus-associated sensory neuropathy . J Neurovirol. 2006;12:328-331.
10.
Gilron I., Watson CP, Cahill CM, Moulin DENeuropathic pain: a practical guide for the clinician. CMAJ . 2006;175:265-275.
11.
Burton C., Maurer DDPain suppression by transcutaneous electrical nerve stimulation. IEEE Trans Biomed Eng. 1974;21:81-88.
12.
Galer BSNeuropathic pain of peripheral origin: advances in pharmacologic treatment . Neurology. 1995;45:S17-S25.
13.
Abuaisha BB , Costanzi JB, Boulton AJAcupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study . Diabetes Res Clin Pract. 1998;39:115-121.
14.
McQuay H., Carroll D., Jadad AR, Wiffen P., Moore A.Anticonvulsant drugs for management of pain: a systematic review. BMJ. 1995;311:1047-1052.
15.
Kingery WSA critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain. 1997;73:123-139.
16.
McQuay HJ, Tramer M., Nye BA, Carroll D., Wiffen PJ, Moore RAA systematic review of antidepressants in neuropathic pain. Pain. 1996;68:217-227.
17.
Watson CP, Vernich L., Chipman M., Reed K.Nortriptyline versus amitriptyline in postherpetic neuralgia: a randomized trial. Neurology. 1998;51:1166-1171.
18.
Max MB, Kishore-Kumar R., Schafer AC, et al. Efficacy of desipramine in painful diabetic neuropathy: a placebo-controlled trial. Pain. 1991;45:3-9.
19.
Max MB, Lynch SA, Muir J., Shoaf SE, Smoller B., Dubner R.Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. N Engl J Med. 1992;326:1250-1256.
20.
Cohen KL, Harris S.Efficacy and safety of nonsteroidal anti-inflammatory drugs in the therapy of diabetic neuropathy. Arch Intern Med. 1987 ;147:1442-1444.
21.
Moosa RS, McFadyen ML, Rubin J.Carbamazepine and its metabolites in neuralgias: concentration-effect relations . Eur J Clin Pharmacol. 1993;45:297-301.
22.
Bleakman D. , Alt A., Nisenbaum ESGlutamate receptors and pain. Semin Cell Dev Biol. 2006;17:592-604.
23.
Lipton SAPathologically-activated therapeutics for neuroprotection: mechanism of NMDA receptor block by memantine and S-nitrosylation. Curr Drug Targets. 2007;8:621-632.
24.
Sinis N., Birbaumer N., Gustin S., et al. Memantine treatment of complex regional pain syndrome, preliminary report of six cases. Clin J Pain. 2007;23:237-240.
25.
Wiech K., Kiefer RT, Topfner S., et al. Placebo-controlled randomized crossover trial of the N-methyl-D-aspartic acid receptor antagonist, memantine, in patients with chronic phantom limb pain. Anesth Analg. 2004;98:408-413.
26.
Schifitto G. , Yiannoutsos CT, Simpson DM, et al. A placebo-controlled study of memantine for the treatment of human immunodeficiency virus-associated sensory neuropathy . J Neurovirol. 2006;12:328-331.
