A placebo-controlled randomized crossover trial of the N-methyl-D-aspartic acid receptor antagonist, memantine, in patients with chronic phantom limb pain

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#adult #amputation-surgical #chronic-disease #cross-over-studies #double-blind-method

A placebo-controlled randomized crossover trial of the N-methyl-D-aspartic acid receptor antagonist, memantine, in patients with chronic phantom limb pain

Wiech et al., 2004 | Anesth Analg | Rct

Citation

Wiech Katja, Kiefer Ralph-Thomas, ... Birbaumer Niels. A 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-Feb;98(2):408-413. doi:10.1213/01.ANE.0000096002.53818.BD

Abstract

UNLABELLED: In the present study we investigated the effect of the N-methyl-D-aspartic acid (NMDA) receptor antagonist memantine (30 mg/d) on the intensity of chronic phantom limb pain (PLP) and cortical reorganization. In 8 patients with chronic PLP, memantine was tested in a placebo-controlled double-blinded crossover trial of 4 wk duration per trial. The intensity of PLP was rated hourly by the patients on a visual analog scale during baseline and both treatment periods. At the same time points, the functional organization of the primary somatosensory cortex (SI) was determined by neuromagnetic source imaging. In comparison to baseline and placebo, the NMDA receptor antagonist had no effect on the intensity of chronic PLP. In none of the periods were significant changes in the functional organization of SI observed. Although the conclusions regarding the clinical effect are limited because of the small sample size, the data indicate that in the studied dosage the NMDA receptor antagonist memantine is ineffective in the treatment of chronic PLP and is also ineffective for the reduction of associated neural plasticity in the primary SI. IMPLICATIONS: NMDA receptors play a substantial role in central nervous system changes underlying neuropathic pain. In a placebo-controlled double-blinded study we tested the effect of 30 mg memantine on chronic phantom limb pain and pain-associated cortical reorganization.

Key Findings

In a placebo-controlled double-blinded study we tested the effect of 30 mg memantine on chronic phantom limb pain and pain-associated cortical reorganization.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population chronic plp
Sample Size 8
Age Range See abstract
Condition See abstract

MeSH Terms

  • Adult
  • Amputation, Surgical
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Excitatory Amino Acid Antagonists
  • Female
  • Functional Laterality
  • Humans
  • Magnetoencephalography
  • Male
  • Memantine
  • Middle Aged
  • Pain Measurement
  • Phantom Limb
  • Receptors, N-Methyl-D-Aspartate
  • Treatment Outcome

Evidence Classification

  • Level: Rct
  • Publication Types: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
  • Vertical: d-aspartic-acid

Provenance

Source extracted via PubMed E-utilities API on 2026-04-12