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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Improvement of negative and positive symptoms in treatment-refractory schizophrenia: A double-blind, randomized, placebo-controlled trial with memantine as add-on therapy to clozapine
Journal of Clinical Psychiatry, Volume 70, No. 10, Year 2009
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Description
Background: Glutamate deregulation may be involved in the neuropathology of schizophrenia, mainly through N-methyl-D-aspartate (NMDA) receptor dysfunction. Memantine, a drug approved by the FDA for the treatment of moderate to severe Alzheimer's disease, acts as a weak nonselective NMDA receptor antagonist. The aim of this study was to examine the efficacy of memantine as an adjunctive treatment to clozapine in patients with refractory schizophrenia. Method: In this double-blind, placebo-controlled study, outpatients with refractory schizophrenia according to DSM-IV clinical criteria were randomly assigned, from March 2005 to February 2008, to receive either 20 mg/d memantine (n = 10) or placebo (n = 11), in addition to clozapine, for 12 weeks. The primary outcome measure was the total score on the 18-item Brief Psychiatry Rating Scale (BPRS) and BPRS subscales of positive and negative symptoms. Secondary outcomes were global severity of disease as measured by the Clinical Global Impressions scale (CGI), cognition as assessed by the Mini-Mental State Examination (MMSE), and extrapyramidal symptoms as assessed by the Simpson-Angus Scale (SAS). Results: Twenty-one participants completed the study and were used in the analysis. Significant improvement (P < .01) on the total BPRS score, its subscales of positive (effect size [ES] = -1.38) and negative (ES = -3.33) symptoms, the CGI score (ES = 1.56), and the MMSE score was observed with memantine as compared with placebo. No significant changes in extrapyramidal symptoms were observed. Conclusions: Memantine add-on to clozapine therapy was associated with improvement in negative and positive symptoms in refractory schizophrenia patients. Trial Registration: clinicaltrials.gov Identifier: NCT00757978 © Copyright 2009 Physicians Postgraduate Press, Inc.
Authors & Co-Authors
De Lucena, David Freitas
Brazil, Porto Alegre
Universidade Federal do Rio Grande do Sul
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Berk, Michael
Australia, Geelong
Barwon Health
Australia, Melbourne
Orygen Research Centre
Dodd, Seetal M.
Australia, Geelong
Barwon Health
Kunz, Maurício
Brazil, Porto Alegre
Universidade Federal do Rio Grande do Sul
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Lobato, Maria Inês Rodrigues
Brazil, Porto Alegre
Universidade Federal do Rio Grande do Sul
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Gama, Clarissa Severino
Brazil, Porto Alegre
Hospital de Clinicas de Porto Alegre
Brazil, Porto Alegre
Universidade Federal do Rio Grande do Sul
Statistics
Citations: 110
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.4088/JCP.08m04935gry
ISSN:
01606689
Research Areas
Disability
Mental Health