Wei Zheng1, Xiao-Min Zhu2, Qing-E Zhang3, Dong-Bin Cai4, Xin-Hu Yang1, Yan-Ling Zhou1, Gabor S Ungvari5, Chee H Ng6, Shu-Hua He7, Xiao-Jiang Peng8, Yu-Ping Ning9, Yu-Tao Xiang10. 1. The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China. 2. Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, China. 3. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China. 4. Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. 5. The University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia. 6. Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. 7. University of California, Davis, USA. 8. Guangzhou Civil Aviation College, Guangzhou, China. 9. The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China. Electronic address: ningjeny@126.com. 10. Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.
Abstract
OBJECTIVE: As a non-competitive N-methyl-d-aspartate receptor antagonist, memantine has been used to treat major mental disorders including schizophrenia, bipolar disorder, and major depressive disorder (MDD). This meta-analysis systematically investigated the effectiveness and tolerability of adjunctive memantine for patients with schizophrenia, bipolar disorder, and MDD. METHODS: Only randomized controlled trials (RCTs) were identified and included in the study. Data of the three disorders were separately synthesized using the RevMan 5.3 software. RESULTS: Fifteen RCTs (n = 988) examining memantine (5-20 mg/day) as an adjunct treatment for schizophrenia (9 trials with 512 patients), bipolar disorder (3 trials with 319 patients), and MDD (3 trials with 157 patients) were analyzed. Memantine outperformed the comparator regarding total psychopathology with a standardized mean difference (SMD) of -0.56 [95% confidence interval (CI): -1.01, -0.11; I2 = 76%, P = 0.01] and negative symptoms with an SMD of -0.71 (95% CI: -1.09, -0.33; I2 = 74%, P = 0.0003) in schizophrenia, but no significant effects were found with regard to positive symptoms and general psychopathology in schizophrenia, or depressive and manic symptoms in bipolar disorder or depressive symptoms in MDD. Memantine outperformed the comparator in improving cognitive performance in schizophrenia with an SMD of 1.07 (95% CI: 0.53, 1.61; P < 0.0001, I2 = 29%). No group differences were found in the rates of adverse drug reactions and discontinuation due to any reason in the three major mental disorders. CONCLUSIONS: Memantine as an adjunct treatment appears to have significant efficacy in improving negative symptoms in schizophrenia. The efficacy and safety of adjunctive memantine for bipolar disorder or MDD needs to be further examined. REVIEW REGISTRATION: PROSPERO: 42018099045.
OBJECTIVE: As a non-competitive N-methyl-d-aspartate receptor antagonist, memantine has been used to treat major mental disorders including schizophrenia, bipolar disorder, and major depressive disorder (MDD). This meta-analysis systematically investigated the effectiveness and tolerability of adjunctive memantine for patients with schizophrenia, bipolar disorder, and MDD. METHODS: Only randomized controlled trials (RCTs) were identified and included in the study. Data of the three disorders were separately synthesized using the RevMan 5.3 software. RESULTS: Fifteen RCTs (n = 988) examining memantine (5-20 mg/day) as an adjunct treatment for schizophrenia (9 trials with 512 patients), bipolar disorder (3 trials with 319 patients), and MDD (3 trials with 157 patients) were analyzed. Memantine outperformed the comparator regarding total psychopathology with a standardized mean difference (SMD) of -0.56 [95% confidence interval (CI): -1.01, -0.11; I2 = 76%, P = 0.01] and negative symptoms with an SMD of -0.71 (95% CI: -1.09, -0.33; I2 = 74%, P = 0.0003) in schizophrenia, but no significant effects were found with regard to positive symptoms and general psychopathology in schizophrenia, or depressive and manic symptoms in bipolar disorder or depressive symptoms in MDD. Memantine outperformed the comparator in improving cognitive performance in schizophrenia with an SMD of 1.07 (95% CI: 0.53, 1.61; P < 0.0001, I2 = 29%). No group differences were found in the rates of adverse drug reactions and discontinuation due to any reason in the three major mental disorders. CONCLUSIONS:Memantine as an adjunct treatment appears to have significant efficacy in improving negative symptoms in schizophrenia. The efficacy and safety of adjunctive memantine for bipolar disorder or MDD needs to be further examined. REVIEW REGISTRATION: PROSPERO: 42018099045.
Authors: Katharina O Sandström; Olga B Baltzersen; Anouk Marsman; Cecilie K Lemvigh; Vincent O Boer; Kirsten B Bojesen; Mette Ø Nielsen; Henrik Lundell; Daban K Sulaiman; Mikkel E Sørensen; Birgitte Fagerlund; Adrienne C Lahti; Warda T Syeda; Christos Pantelis; Esben T Petersen; Birte Y Glenthøj; Hartwig R Siebner; Bjørn H Ebdrup Journal: Front Psychiatry Date: 2022-05-20 Impact factor: 5.435
Authors: Neal R Swerdlow; Savita G Bhakta; Jo Talledo; Juliana Kotz; Benjamin Z Roberts; Royce Ellen Clifford; Michael L Thomas; Yash B Joshi; Juan L Molina; Gregory A Light Journal: Neuropsychopharmacology Date: 2020-09-22 Impact factor: 7.853