Effectiveness and Safety of Memantine for Headache: A Meta-analysis of Randomized Controlled Studies.

OBJECTIVE: The effectiveness and safety of memantine for headache are elusive, and this meta-analysis aimed to explore the influence of memantine versus placebo for headache. METHODS: We searched PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through May 2021 and included randomized controlled trials reporting memantine versus placebo for headache patients. This meta-analysis was performed using the random-effects model. RESULTS: Our meta-analysis included 4 randomized controlled trials and 229 patients. Compared with control group for headache, memantine treatment could substantially reduce headache days (mean difference [MD] = -3.10; 95% confidence interval [CI] = -5.46 to -0.75; P = 0.01), pain intensity (MD, -0.43; 95% CI, -0.85 to -0.01; P = 0.04), monthly attack frequency (MD, -2.14; 95% CI, -2.83 to -1.46; P < 0.00001), and Migraine Disability Assessment Test (MD, -5.63; 95% CI, -6.46 to -4.79; P < 0.00001) but revealed no significant influence on days for acute pain medications, adverse events, or nausea/vomiting. CONCLUSIONS: Memantine treatment is effective and safe to treat headache.

The Efficacy of Lasmiditan for the Treatment of Migraine: A Meta-Analysis of Randomized Controlled Studies.

INTRODUCTION: The efficacy of lasmiditan is used to alleviate migraine. We conduct a systematic review and meta-analysis to explore the influence of lasmiditan versus placebo on pain control in patients with migraine. METHODS: We search the PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2020 for randomized controlled trials (RCTs) assessing the effect of lasmiditan versus placebo on pain control in patients with migraine. This meta-analysis was performed using the random effects model. RESULTS: Four randomized controlled trials are included in the meta-analysis. Overall, compared with the control group, in patients with migraine, lasmiditan treatment shows positive impact on pain free at 2 hours [risk ratio (RR), 1.74; 95% confidence interval (CI), 1.47-2.07; P < 0.00001], headache response at 2 hours (RR, 1.38; 95% CI, 1.28-1.49; P < 0.00001), pain free at 24 hours (RR, 1.55; 95% CI, 1.16-2.07; P = 0.003), and no or mild disability level (RR, 1.20; 95% CI, 1.11-1.29; P < 0.00001), but has no obvious influence on nausea (RR, 2.22; 95% CI, 0.92-5.35; P = 0.08). In addition, lasmiditan seems to result in the increase in dizziness (RR, 6.36; 95% CI, 3.00-13.46; P < 0.0001) and paresthesia (RR, 5.10; 95% CI, 2.66-9.78; P < 0.00001). CONCLUSIONS: Lasmiditan treatment provides additional benefits for pain control in patients with migraine.

Influence of greater occipital nerve block on pain severity in migraine patients: A systematic review and meta-analysis.

AIMS: Greater occipital nerve (GON) block may be a promising approach to treat migraine. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of GON block in migraine patients. METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the efficacy of GON block versus placebo in migraine patients were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Meta-analysis was performed using the random-effect model. RESULTS: Six RCTs were included in the meta-analysis. Overall, compared with control intervention in migraine patients, GON block intervention was found to significantly reduce pain score (Std. mean difference=-0.51; 95% CI=-0.81 to -0.21; P=0.0008), number of headache days (Std. mean difference=-0.68; 95% CI=-1.02 to -0.35; P<0.0001), and medication consumption (Std. mean difference=-0.35; 95% CI=-0.67 to -0.02; P=0.04), but demonstrated no influence on duration of headache per four weeks (Std. mean difference=-0.07; 95% CI=-0.41 to 0.27; P=0.70). CONCLUSIONS: Compared to control intervention, GON block intervention can significantly alleviate pain, reduce the number of headache days and medication consumption, but have no significant influence on the duration of headache per four weeks for migraine patients.