Posted by SLS on June 21, 2012, at 10:07:54
In reply to Re: Memantine for Depression - How long to wait? » SLS, posted by phidippus on June 19, 2012, at 17:30:49
I was disappointed to see this:
http://www.ncbi.nlm.nih.gov/pubmed/22329473
- Scott-----------------------------------------
Bipolar Disord. 2012 Feb;14(1):64-70. doi: 10.1111/j.1399-5618.2011.00971.x.
Early antidepressant effect of memantine during augmentation of lamotrigine inadequate response in bipolar depression: a double-blind, randomized, placebo-controlled trial.
Anand A, Gunn AD, Barkay G, Karne HS, Nurnberger JI, Mathew SJ, Ghosh S.
SourceDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA. aanand@iupui.edu
Abstract
BACKGROUND:Recent studies indicate that modulation of glutamate neurotransmission is associated with antidepressant response. Lamotrigine, an anticonvulsant which decreases presynaptic glutamate release, has been shown to be effective in the depressive phase of bipolar disorder (BD-D); however, only 40-50% of patients have a full response. This pilot study investigated whether memantine, a low-affinity N-methyl-D-aspartate (NMDA) receptor antagonist approved for Alzheimer's disease, can augment the effects of lamotrigine.
METHODS:BD-D outpatients in a major depressive episode on a stable dose of lamotrigine (100 mg or more) were randomized to either memantine (starting dose of 5 mg increased up to 20 mg over four weeks, then 20 mg stable dose from four to eight weeks) or matching pill placebo for eight weeks. Patients were rated on the 17-item Hamilton Depression Rating Scale (HDRS) and other behavioral measures weekly.
RESULTS:The eight-week repeated-measures mixed-effect model for HDRS was not significant for memantine (n = 14) versus placebo (n = 15). Exploratory mixed-effect analyses for the first four weeks, while the memantine dose was being titrated up every week, revealed a significant decrease in HDRS scores from baseline (p = 0.007).
CONCLUSION:This proof-of-concept study failed to show a statistically significant benefit of memantine augmentation of lamotrigine for patients with BD-D over eight weeks. However, memantine had an antidepressant effect early on in the treatment while its dose was being titrated up. Larger placebo-controlled studies are needed to ascertain optimal timing and dosing for memantine augmentation of lamotrigine in BD-D.
© 2012 John Wiley and Sons A/S.
PMID:
22329473
[PubMed - indexed for MEDLINE]Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1019496
URL: http://www.dr-bob.org/babble/20120608/msgs/1019995.html