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Memantine Bipolar

Francesca Demontis, Francesca Serra, Gino Serra
BACKGROUND: Mania seems to be associated with an increased dopamine (DA) transmission. Antidepressant treatments can induce mania in humans and potentiated DA transmission in animals, by sensitizing DA D2 receptors in the mesolimbic system. We have suggested that the sensitization of D2 receptors may be responsible of antidepressant-induced mania. This review aims to report the experimental evidence that led to the hypothesis that antidepressant-induced DA receptors dysregulation can be considered an animal model of bipolar disorder...
July 15, 2016: Current Neuropharmacology
Nicola Veronese, Marco Solmi, Claudio Luchini, Ru-Band Lu, Brendon Stubbs, Leonardo Zaninotto, Christoph U Correll
BACKGROUND: Acetylcholinesterase inhibitors (AceI) and memantine might prove useful in bipolar disorder (BD) given their neuroprotective and pro-cognitive effects, as highlighted by several case reports. We aimed to systematically review the efficacy and safety of AceI and memantine across multiple outcome dimensions in BD. METHODS: Systematic PubMed and SCOPUS search until 04/17/2015 without language restrictions. Included were randomized controlled trials (RCTs), open label studies and case series of AceI or memantine in BD patients reporting quantitative data on depression, mania, psychotic symptoms, global functioning, or cognitive performance...
June 2016: Journal of Affective Disorders
Giuseppe Quaranta, Angelo Giovanni Icro Maremmani, Giulio Perugi
Background. Autoimmune encephalitis is a disorder characterised by the subacute onset of seizures, short-term memory loss, and psychiatric and behavioural symptoms. Initially, it was recognised as a paraneoplastic disorder, but recently a subgroup of patients without systemic cancer was identified. Case Description. We describe a 20-year-old woman with Turner syndrome presenting with a treatment-resistant rapid cycling bipolar disorder with cognitive impairment. She was diagnosed with anti-AMPA-receptor encephalitis...
2015: Case Reports in Psychiatry
S Dimitrakopoulos, G Konstantakopoulos
The treatment of bipolar disorder is a current challenge for clinicians and despite progress in psychopharmacology, options remain limited and results are often unsatisfactory. Current research focuses on finding new pharmaceutical agents for all phases of bipolar disorder, i.e. mania, bipolar depression and maintenance. Particularly, relapse prevention and longterm stabilization is a major therapeutic target. Combination treatment and polypharmacy are the most common choices concerning relapse prevention. Furthermore, during maintenance phase patients often experience residual mood symptoms, cognitive deficits and functional decline, which altogether illustrate the inadequate effectiveness of existing treatments and the need for new, targeted, effective and safe treatments for bipolar disorder...
July 2015: Psychiatrikē, Psychiatriki
Shi Hui Poon, Kang Sim, Ross J Baldessarini
Bipolar disorder is prevalent, with high risks of disability, substance abuse and premature mortality. Treatment responses typically are incomplete, especially for depressive components, so that many cases can be considered "treatment resistant." We reviewed reports on experimental treatments for such patients: there is a striking paucity of such research, mainly involving small incompletely controlled trials of add-on treatment, and findings remain preliminary. Encouraging results have been reported by adding aripiprazole, bupropion, clozapine, ketamine, memantine, pramipexole, pregabalin, and perhaps tri-iodothyronine in resistant manic or depressive phases...
2015: Current Neuropharmacology
Tayla L McCloud, Caroline Caddy, Janina Jochim, Jennifer M Rendell, Peter R Diamond, Claire Shuttleworth, Daniel Brett, Ben H Amit, Rupert McShane, Layla Hamadi, Keith Hawton, Andrea Cipriani
BACKGROUND: There is emerging evidence that glutamatergic system dysfunction might play an important role in the pathophysiology of bipolar depression. This review focuses on the use of glutamate receptor modulators for depression in bipolar disorder. OBJECTIVES: 1. To assess the effects of ketamine and other glutamate receptor modulators in alleviating the acute symptoms of depression in people with bipolar disorder.2. To review the acceptability of ketamine and other glutamate receptor modulators in people with bipolar disorder who are experiencing acute depression symptoms...
2015: Cochrane Database of Systematic Reviews
Francesca Demontis, Marcella Falconi, Desirèe Canu, Gino Serra
A great deal of evidence suggests that virtually all antidepressant treatments induce a dopaminergic behavioral supersensitivity. We have suggested that this effect may play a key role not only in the antidepressant effect of these treatments, but also in their ability to induce a switch from depression to mania. In 2003-4 we found that the sensitization of dopamine receptors induced by imipramine is followed, after imipramine withdrawal, by a desensitization of these receptors associated with a depressive-like behavior assessed in the forced swimming test...
April 5, 2015: European Journal of Pharmacology
Giulia Serra, Athanasios Koukopoulos, Lavinia De Chiara, Alexia E Koukopoulos, Leonardo Tondo, Paolo Girardi, Ross J Baldessarini, Gino Serra
BACKGROUND: Developing safe and effective long-term treatments for bipolar disorder remains a major challenge. Given available treatments, patients with bipolar disorder remain unwell in half of long-term follow-up, mostly in depression. As memantine, an N-methyl-D-aspartate (NMDA)-glutamate receptor antagonist used to treat dementia, has been proposed for testing in bipolar disorder, we carried out a 3 + 3-year, mirror-image, chart-review study of the effects of adding memantine to stably continued, but insufficiently effective, ongoing mood-stabilizing treatments...
January 2015: Journal of Clinical Psychiatry
Giulia Serra, Francesca Demontis, Francesca Serra, Lavinia De Chiara, Andrea Spoto, Paolo Girardi, Giulio Vidotto, Gino Serra
UNLABELLED: We review preclinical and clinical evidences strongly suggesting that memantine, an old drug currently approved for Alzheimer's dementia, is an effective treatment for acute mania and for the prevention of manic/hypomanic and depressive recurrences of manic-depressive illness. Lithium remains the first line for the treatment and prophylaxis of bipolar disorders, but currently available treatment alternatives for lithium resistant patients are of limited and/or questionable efficacy...
December 22, 2014: World Journal of Psychiatry
Lavinia De Chiara, Giulia Serra, Alexia Emilia Koukopoulos, Athanasios Koukopoulos, Gino Serra
We have recently reported that memantine has a clinically relevant antimanic and long-lasting mood-stabilizing effect in treatment- resistant bipolar disorders, both as augmenting agent and as a monotherapy. Moreover, we observed an acute antimanic and sustained mood-stabilizing effect also in "naïve" bipolar type I disorder. Here we report a case history of a young woman suffering from bipolar type II mood disorder, associated with a very severe eating disorder, showing an acute antimanic and a long-term prophylactic effect of memantine on bipolar disorder and comorbid eating disorder...
July 2014: Rivista di Psichiatria
Giulia Serra, Lavinia DE Chiara, Alexia Emilia Koukopoulos, Athanasios Koukopoulos, Gino Serra, David A Kahn
We have recently reported that memantine has a clinically relevant antimanic and long-lasting mood-stabilizing effect in treatment-resistant bipolar disorders, both as augmenting agent and as monotherapy. We have also observed an acute antimanic and sustained mood-stabilizing effect in a small number of patients with bipolar I disorder who had had minimal previous pharmacotherapy. In this article, we report the case of a young woman suffering from bipolar II disorder with associated fibromyalgia, in whom memantine showed an acute antimanic and a long-term prophylactic effect on both bipolar disorder as well as the associated fibromyalgia syndrome...
May 2014: Journal of Psychiatric Practice
Sheng-Yu Lee, Shiou-Lan Chen, Yun-Hsuan Chang, Po See Chen, San-Yuan Huang, Nian-Sheng Tzeng, Yu-Shan Wang, Liang-Jen Wang, I Hui Lee, Tzu-Yun Wang, Tzung Lieh Yeh, Yen Kuang Yang, Jau-Shyong Hong, Ru-Band Lu
Memantine, a noncompetitive N-methyl-d-aspartate receptor antagonist with a mood-stabilizing effect, and an association between bipolar disorder and proinflammatory cytokine levels have been reported. Whether adding-on memantine would reduce cytokine levels and is more effective than valproic acid (VPA) alone in bipolar II disorder was investigated. A randomized, double-blind, controlled, 12-week study was conducted. Patients undergoing regular VPA treatments were randomly assigned to a group: VPA + memantine (5 mg/d) (n = 106) or VPA + placebo (n = 108)...
June 2014: Journal of Clinical Psychopharmacology
Giulia Serra, Lavinia De Chiara, Giovanni Manfredi, Alexia E Koukopoulos, Gabriele Sani, Paolo Girardi, Athanasios Koukopoulos, Gino Serra
No abstract text is available yet for this article.
February 2014: Therapeutic Advances in Psychopharmacology
Dominik Strzelecki, Agnieszka Tabaszewska, Zbigniew Barszcz, Olga Józefowicz, Paweł Kropiwnicki, Jolanta Rabe-Jabłońska
Memantine and other glutamatergic agents have been currently investigated in some off-label indications due to glutamatergic involvement in several psychoneurological disorders. We assumed that memantine similarly to ketamine may positively influence mood, moreover having a potential to improve cognition and general quality of life. We report a case of a 49-year-old male hospitalized during a manic and a subsequent moderate depressive episode. After an ineffective use of lithium, olanzapine and antidepressive treatment with mianserin, memantine was added up to 20 mg per day for 10 weeks...
December 2013: Psychiatry Investigation
Yong-Hui Dang, Xian-Cang Ma, Ji-Chun Zhang, Qian Ren, Jin Wu, Cheng-Ge Gao, Kenji Hashimoto
Major depressive disorder (MDD) is a common, recurrent mental illness that affects millions of people worldwide. Accumulating evidence suggests that the N-methyl-D-aspartate (NMDA) receptor, a subtype of glutamate receptors, plays an important role in the neurobiology and treatment of this disease. Currently, the non-competitive NMDA receptor antagonist ketamine is considered as one of the most attractive candidate drugs in therapy of treatment-resistant depression. A recent study demonstrated ketamine's rapid antidepressant activity in patients with treatment-resistant MDD and bipolar disorder...
2014: Current Pharmaceutical Design
D Kontis, I Theochari, E Tsalta
Dementia and bipolar disorder have been traditionally considered two separate clinical entities. However, recent preclinical and clinical data in elderly people suggest that they are in fact related. Several theories have been put forward to interpret their relationship which could be summed up as follows: (1) Dementia could increase the risk for the emergence of bipolar symptoms, or (2) conversely, bipolar disorder might be associated with heightened risk for developing pseudodementia or dementia. (3) Alternatively, dementia, other brain diseases or drugs affecting brain function could lead to the combination of symptoms of dementia and bipolar disorder in elderly individuals...
April 2013: Psychiatrikē, Psychiatriki
Sheng-Yu Lee, Shiou-Lan Chen, Yun-Hsuan Chang, Shih-Heng Chen, Chun-Hsieh Chu, San-Yuan Huang, Nian-Sheng Tzeng, Chen-Lin Wang, Liang-Jen Wang, I Hui Lee, Tzung Lieh Yeh, Yen Kuang Yang, Jau-Shyong Hong, Ru-Band Lu
Memantine is a non-competitive N-methyl-d-asparate (NMDA) receptor antagonist with a mood-stabilizing effect. We investigated whether using valproic acid (VPA) plus add-on memantine to treat bipolar II disorder (BP-II) is more effective than using VPA alone (VPA + Pbo). We also evaluated, in BP-II patients, the association between the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism with treatment response to VPA + add-on memantine and to VPA + Pbo. In this randomized, double-blind, controlled 12 wk study, BP-II patients undergoing regular VPA treatments were randomly assigned to a group: VPA + Memantine (5 mg/day) (n = 115) or VPA + Pbo (n = 117)...
February 2014: International Journal of Neuropsychopharmacology
Sheng-Yu Lee, Shiou-Lan Chen, Yun-Hsuan Chang, Po See Chen, San-Yuan Huang, Nian-Sheng Tzeng, Yu-Shan Wang, Liang-Jen Wang, I Hui Lee, Tzung Lieh Yeh, Yen Kuang Yang, Ru-Band Lu, Jau-Shyong Hong
UNLABELLED: Memantine is a noncompetitive NMDA receptor antagonist. As an augmenting agent, it has an antidepressant-like and mood-stabilizing effect. Memantine also reduces binge eating episodes and weight. We investigated whether memantine added on to valproate (VPA) is more effective than VPA alone for treating BP-II depression and improving the patient's metabolic profile. This was a randomized, double-blind, controlled study. BP-II patients undergoing regular VPA treatments were randomly assigned to one of two groups: VPA plus either add-on [1] memantine (5 mg/day) (n = 62) or [2] placebo (n = 73) for 12 weeks...
October 2013: Journal of Psychiatric Research
Rif S El-Mallakh, Ahmed Z Elmaadawi, Yonglin Gao, Kavita Lohano, R Jeannie Roberts
Bipolar disorder is a complex condition to treat because agents that may be effective for a specific phase may not be effective for other phases, or may even worsen the overall course of the illness. Over the last decade there has been an increase in research activity in the treatment of bipolar illness. There are now several agents that are well established for the treatment of acute mania (lithium, divalproex, carbamazepine, nearly all antipsychotics), acute bipolar depression (lamotrigine, quetiapine, olanzapine/fluoxetine combination), and relapse prevention (lithium, lamotrigine, divalproex, most second generation antipsychotics)...
2011: Journal of Central Nervous System Disease
Taro Kishi, Nakao Iwata
BACKGROUND: We examined whether N-methyl d-aspartate (NMDA) receptor antagonists as adjunctive therapy have therapeutic potential for schizophrenia treatment. METHOD: Systematic review of PubMed, Cochrane Library, PsycINFO and Google Scholar up until October 2012 and meta-analysis of randomized placebo-controlled trials were performed. Risk ratio (RR), 95% confidence intervals (CI), numbers-needed-to-harm (NNH), and standardized mean difference (SMD) were calculated...
September 2013: Journal of Psychiatric Research
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