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

Authors

1 Department of Psychiatry, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Epidemiology, Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

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 12th 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.

Keywords

1.
Palmer BW, Martin AS, Depp CA, Glorioso DK, Jeste DV. Wellness within illness: Happiness in schizophrenia. Schizophr Res 2014;159:151-6.  Back to cited text no. 1
    
2.
Irmak MK. Schizophrenia or possession? J Relig Health 2014;53:773-7.  Back to cited text no. 2
    
3.
Bosia M, Pigoni A, Cavallaro R. Genomics and epigenomics in novel schizophrenia drug discovery: Translating animal models to clinical research and back. Expert Opin Drug Discov 2015;10:125-39.  Back to cited text no. 3
    
4.
Lee JG, Lee SW, Lee BJ, Park SW, Kim GM, Kim YH. Adjunctive memantine therapy for cognitive impairment in chronic schizophrenia: A placebo-controlled pilot study. Psychiatry Investig 2012;9:166-73.  Back to cited text no. 4
    
5.
Galuppi A, Turola MC, Nanni MG, Mazzoni P, Grassi L. Schizophrenia and quality of life: How important are symptoms and functioning? Int J Ment Health Syst 2010;4:31.  Back to cited text no. 5
    
6.
Eack SM, Newhill CE. Psychiatric symptoms and quality of life in schizophrenia: A meta-analysis. Schizophr Bull 2007;33:1225-37.  Back to cited text no. 6
    
7.
Bobes J, Garcia-Portilla MP, Bascaran MT, Saiz PA, Bousoño M. Quality of life in schizophrenic patients. Dialogues Clin Neurosci 2007;9:215-26.  Back to cited text no. 7
    
8.
John JP, Lukose A, Manjunath S. Off-label use of memantine as adjunctive treatment in schizophrenia: A retrospective case series study. Pharmacopsychiatry 2014;47:202-9.  Back to cited text no. 8
    
9.
Coyle JT. NMDA receptor and schizophrenia: A brief history. Schizophr Bull 2012;38:920-6.  Back to cited text no. 9
    
10.
Hashimoto K. Targeting of NMDA receptors in new treatments for schizophrenia. Expert Opin Ther Targets 2014;18:1049-63.  Back to cited text no. 10
    
11.
Attari A, Rajabi F, Maracy MR. D-cycloserine for treatment of numbing and avoidance in chronic post traumatic stress disorder: A randomized, double blind, clinical trial. J Res Med Sci 2014;19:592-8.  Back to cited text no. 11
  Medknow Journal  
12.
Omranifard V, Shirzadi E, Samandari S, Afshar H, Maracy MR. Memantine add on to citalopram in elderly patients with depression: A double-blind placebo-controlled study. J Res Med Sci 2014;19:525-30.  Back to cited text no. 12
[PUBMED]  Medknow Journal  
13.
Choi KH, Wykes T, Kurtz MM. Adjunctive pharmacotherapy for cognitive deficits in schizophrenia: Meta-analytical investigation of efficacy. Br J Psychiatry 2013;203:172-8.  Back to cited text no. 13
    
14.
Lane HY, Lin CH, Huang YJ, Liao CH, Chang YC, Tsai GE. A randomized, double-blind, placebo-controlled comparison study of sarcosine (N-methylglycine) and D-serine add-on treatment for schizophrenia. Int J Neuropsychopharmacol 2010;13:451-60.  Back to cited text no. 14
    
15.
Paraschakis A. Tackling negative symptoms of schizophrenia with memantine. Case Rep Psychiatry 2014;2014:384783.  Back to cited text no. 15
    
16.
Aas IH. Global Assessment of Functioning (GAF): Properties and frontier of current knowledge. Ann Gen Psychiatry 2010;9:20.  Back to cited text no. 16
    
17.
Hosenbocus S, Chahal R. Memantine: A review of possible uses in child and adolescent psychiatry. J Can Acad Child Adolesc Psychiatry 2013;22:166-71.  Back to cited text no. 17
    
18.
Sani G, Serra G, Kotzalidis GD, Romano S, Tamorri SM, Manfredi G, et al. The role of memantine in the treatment of psychiatric disorders other than the dementias: A review of current preclinical and clinical evidence. CNS Drugs 2012;26:663-90.  Back to cited text no. 18
    
19.
Ghaleiha A, Entezari N, Modabbernia A, Najand B, Askari N, Tabrizi M, et al. Memantine add-on in moderate to severe obsessive-compulsive disorder: Randomized double-blind placebo-controlled study. J Psychiatr Res 2013;47:175-80.  Back to cited text no. 19
    
20.
Lee SY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, et al. Add-on memantine to valproate treatment increased HDL-C in bipolar II disorder. J Psychiatr Res 2013;47:1343-8.  Back to cited text no. 20
    
21.
Ghaleiha A, Asadabadi M, Mohammadi MR, Shahei M, Tabrizi M, Hajiaghaee R, et al. Memantine as adjunctive treatment to risperidone in children with autistic disorder: A randomized, double-blind, placebo-controlled trial. Int J Neuropsychopharmacol 2013;16:783-9.  Back to cited text no. 21
    
22.
Kavirajan H. Memantine: A comprehensive review of safety and efficacy. Expert Opin Drug Saf 2009;8:89-109.  Back to cited text no. 22
    
23.
Krivoy A, Weizman A, Laor L, Hellinger N, Zemishlany Z, Fischel T. Addition of memantine to antipsychotic treatment in schizophrenia inpatients with residual symptoms: A preliminary study. Eur Neuropsychopharmacol 2008;18:117-21.  Back to cited text no. 23
    
24.
Fakhari A, Herizchi S, Goldust M, Yousefi-Jafarabadi A. The efficacy of complementary use of memantine in treatment of schizophrenia with chronic course. J Am Sci 2013;9:71-4.  Back to cited text no. 24
    
25.
Lieberman JA, Papadakis K, Csernansky J, Litman R, Volavka J, Jia XD, et al. A randomized, placebo-controlled study of memantine as adjunctive treatment in patients with schizophrenia. Neuropsychopharmacology 2009;34:1322-9.  Back to cited text no. 25