Anxiety Disorders

Effects of memantine in anxiety disorders are inconsistent. The authors note that studies of memantine in generalized anxiety disorder (GAD) have been “disappointing.” However, the drug showed promising results in obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Case studies of memantine as adjunctive therapy in patients with OCD whose symptoms were refractory to ordinary first-line treatments found it to be helpful in bringing symptomatic relief and reducing scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).7,8 An open-label trial and a single-blind case-control study both showed improvement in patients with OCD receiving treatment with memantine.9,10 Several case studies of memantine in refractory PTSD found it to be helpful in improving an array of symptoms, including memory, mood, and concentration and decreasing hyperarousal, avoidance, and anger.

Other Disorders


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Evidence for the utility of memantine in other psychiatric disorders is sparse and inconsistent. In drug and alcohol abuse, memantine was somewhat helpful in reducing cravings, but did not yield other positive benefits.2 The NMDA receptor system has been implicated in eating disorders, implying utility of memantine in treating these conditions, the authors suggest. Animal models have yielded promising results, and a small open-label study found it helpful in reducing frequency of binging episodes in 16 patients with binge eating disorder.11

Conclusion

The authors point to a discrepancy between preclinical animal research and human clinical studies of human beings and encourage further study of this promising agent in human beings.

References

1.  Forest Pharmaceuticals, Inc. Namenda Tablets/Oral Solution. Available at:http://www.frx.com/pi/namenda_pi.pdf. Accessed: March 6, 2013.

2.  Sani G, Serra G, Kotzalidis GD, et al. The role of memantine in the treatment of psychiatric disorders other than the dementias. CNS Drugs. 2012;26(8):663-690.

3.  Rodda J, Carter J. Cholinesterase inhibitors and memantine for symptomatic treatment of dementia. BMJ.2012;344:e2986.

4.  Cousins DA, Butts K, Young AH. The role of dopamine in bipolar disorder. Bipolar Disord. 2009;11(8):787-806.

5.  La Spada AR. Memantine strikes the perfect balance. Nat Med. 2009;15(12):1355-1356.

6.  Coyle JT, Basu A, Benneyworth M, et al. Glutamatergic synaptic dysregulation in schizophrenia: therapeutic implications. Handb Exp Pharmacol. 2012;(213):267-295.

7.  Hezel DM, Beattie K, Stewart SE. Memantine as an augmenting agent for severe pediatric OCD. Am J Psychiatry 2009;166(2):237.

8.  Pasquini M, Biondi M. Memantine augmentation for refractory obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry.2006;30(6):1173-5.

9.  Aboujaoude E, Barry JJ, Gamel N. Memantine augmentation in treatment-resistant obsessive-compulsive disorder: an open-label trial. J Clin Psychopharmacol 2009;29(1):51-5.

10.  Stewart SE, Jenike EA, Hezel DM, et al. A single-blinded case-control study of memantine in severe obsessive-compulsive disorder. JClin Psychopharmacol. 2010;30(1):34-39.

11.  Brennan BP, Roberts JL, Fogarty KV, et al. Memantine in the treatment of binge eating disorder: an open-label, prospective trial. IntJ Eat Disord. 2008;41(6):520-6.