The effect of add-on memantine on positive, negative and depressive symptoms of schizophrenia: a doubleblind, randomized, controlled trial.

treatment of schizophrenia, they don’t adequately address residual positive, negative and depressive symptoms. The aim of the present study is to assess the effect of adjunctive memantine treatment on positive, negative and depressive symptoms of schizophrenia. METHODS: This randomized, placebo-controlled study was conducted in Noor Hospital, Isfahan, Iran, 2013-2014; 32 patients in maintenance treatment were included in each group, using block sampling; inclusion criteria were age 18- 65 years, normal intellectual ability, being diagnosed with schizophrenia for the past two years, being treated with fixed doses of atypical antipsychotic for at least three months before randomization. Exclusion criteria were pregnancy, breast feeding, having received electro-convulsive therapy in the past two weeks, drug or substance abuse and dependence, psychiatric/ neurological comorbidities, and sensitivity to memantine. Patients in the intervention group were treated with memantine plus atypical antipsychotic; while in the control group, patients received placebo and atypical antipsychotic. Patients were assessed by Positive and Negative Symptom Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) initially and every four weeks to the end of the 12th week. Data were analyzed in SPSS 17.0 using t-test, chi square, analysis of variance (ANOVA), and analysis of covariance (ANCOVA). RESULTS: Positive symptoms (p=0.028), negative symptoms (0.004), general psychopathology (p<0.001), depressive symptoms (p<0.001) and total symptom severity (p<0.001) decreased significantly in patients receiving add-on memantine. CONCLUSION: This study shows that, add-on memantine would be helpful, in the adjunctive treatment of depressive, positive, negative and general symptoms in patients with schizophrenia.

Efecto de la terapia adyuvante con memantina en el control de los síntomas positivos, negativos y depresivos de la esquizofrenia: estudio aleatorizado, doble ciego y controlado / The effect of add-on memantine on positive, negative and depressive symptoms of schizophrenia: a double-blind, randomized, controlled trial

Antecedentes. Aunque los fármacos antipsicóticos son el pilar básico del tratamiento de la esquizofrenia, no resuelven adecuadamente los síntomas residuales positivos, negativos y depresivos. El objetivo del presente estudio es evaluar el efecto del tratamiento adyuvante con memantina sobre los síntomas positivos, negativos y depresivos de la esquizofrenia. Métodos. Este estudio aleatorizado, controlado con placebo se ha realizado en el hospital Noor en Isfahan, Irán, de 2013 a 2014. En cada grupo se seleccionaron al azar 32 pacientes con tratamiento de mantenimiento. Los pacientes fueron seleccionados como muestreo en bloque. Los criterios de inclusión fueron: edad de 18 a 65 años, con capacidad mental normal, diagnosticados de esquizofrenia durante los últimos dos años y tratados con dosis fijas de antipsicóticos atípicos al menos durante los tres meses previos a la aleatorización. Los criterios de exclusión incluyeron embarazo, lactancia, tratamiento electroconvulsivo en las últimas dos semanas, abuso y dependencia de sustancias, comorbilidad de trastornos psiquiátricos o neurológicos e hipersensibilidad a la memantina. Los pacientes del grupo de intervención recibieron un fármaco antipsicótico atípico más memantina, mientras que el grupo control recibió el antipsicótico atípico más placebo. Los pacientes fueron evaluados por la Escala de Síntomas positivos y negativos (PANSS) y la Escala de Depresión de Calgary para la Esquizofrenia (CDSS) al inicio y luego cada cuatro semanas hasta el final en la duodécima semana. Los datos se analizaron con SPSS-17 utilizando test t, test de ji cuadrado, análisis de varianza (ANOVA) y análisis de covarianza (ANCOVA). Resultados. En el grupo al que se añadió Memantina los síntomas positivos (p=0,028), los síntomas negativos (0,004), la psicopatología general (p<0,001), los síntomas depresivos (p<0,001) y la gravedad general de los síntomas (p<0,001) disminuyeron significativamente. Conclusión. Este estudio muestra que la adición de memantina podría ser útil como tratamiento adyuvante de los síntomas depresivos, positivos, negativos y síntomas generales en pacientes esquizofrénicos (AU)

Background. Although antipsychotics are the mainstay treatment of schizophrenia, they don’t adequately address residual positive, negative and depressive symptoms. The aim of the present study is to assess the effect of adjunctive memantine treatment on positive, negative and depressive symptoms of schizophrenia. Methods. This randomized, placebo-controlled study was conducted in Noor Hospital, Isfahan, Iran, 2013-2014; 32 patients in maintenance treatment were included in each group, using block sampling; inclusion criteria were age 18-65 years, normal intellectual ability, being diagnosed with schizophrenia for the past two years, being treated with fixed doses of atypical antipsychotic for at least three months before randomization. Exclusion criteria were pregnancy, breast-feeding, having received electro-convulsive therapy in the past two weeks, drug or substance abuse and dependence, psychiatric/ neurological comorbidities, and sensitivity to memantine. Patients in the intervention group were treated with memantine plus atypical antipsychotic; while in the control group, patients received placebo and atypical antipsychotic. Patients were assessed by Positive and Negative Symptom Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) initially and every four weeks to the end of the 12th week. Data were analyzed in SPSS 17.0 using t-test, chi square, analysis of variance (ANOVA), and analysis of covariance (ANCOVA). Results. Positive symptoms (p=0.028), negative symptoms (0.004), general psychopathology (p<0.001), depressive symptoms (p<0.001) and total symptom severity (p<0.001) decreased significantly in patients receiving add-on memantine. Conclusion. This study shows that, add-on memantine would be helpful, in the adjunctive treatment of depressive, positive, negative and general symptoms in patients with schizophrenia (AU)

The effect of add-on memantine on global function and quality of life in schizophrenia: A randomized, double-blind, controlled, clinical trial.

BACKGROUND: Schizophrenia severely influences function and quality of life. The benefit of newer antipsychotics in improving the quality of life in schizophrenia still remains controversial. The aim of the present study is to evaluate the effect of memantine on global function and quality of life in patients with schizophrenia. MATERIALS AND METHODS: This was a randomized controlled trial on inpatient cases of schizophrenia in Noor University Hospital, Isfahan, Iran. A number of 64 patients were selected through sequential sampling; patients were randomly allocated in intervention and placebo groups. The intervention group was treated with memantine plus previously administered, stabled-dose, atypical antipsychotic, while the control group received placebo plus previously administered, stabled-dose, atypical antipsychotic. Memantine administration was initiated at 5 mg daily; the dosage was increased at weekly intervals by 5 mg and finally up-titrated to 20 mg daily within 4 weeks. All patients were assessed by means of Global Assessment of Functioning (GAF) and quality of life scale (QLS) initially and every four weeks to the end of the 12(th) week. RESULTS: Analysis of baseline GAF and QLS scores showed no significant differences between the two groups (P = 0.081 and P = 0.225, respectively). GAF and QLS scores increased in both groups; but it was higher in the intervention group. The difference between the two groups was statistically significant. (P < 0.001 and P < 0.001, respectively) memantine was well tolerated, with no significant side effects. CONCLUSION: Add-on memantine was significantly effective in improving the global function of patients as well as their quality of life.