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Omranifard V, Tarrahi MJ, Sharifi S, Karahmadi M. Evaluation of the Effect of Memantine Supplementation in the Treatment of Acute Phase of Mania in Bipolar Disorder of Elderly Patients: A Double-blind Randomized Controlled Trial. Adv Biomed Res 2018; 7:148. [PMID: 30596058 PMCID: PMC6282487 DOI: 10.4103/abr.abr_110_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: This study aimed to evaluate the efficacy of memantine in the acute treatment of geriatric with bipolar disorder (BD) hospitalized for mania. Materials and Methods: This study conducted on 70 patients older than 60 years with BD in the acute phase of mania. Oral sodium valproate was prescribed in both groups. The intervention group received memantine tablet and the placebo group received a placebo tablet based on a same procedure. Severity of mania, cognitive changes, and quality of life (QoL) were assessed and recorded 4 and 8 weeks after the beginning of the study. The collected data were analyzed with SPSS (version 20) using independent samples t-test, analysis of variance in repeated observations, Chi-squared test, and Fisher's exact test. Results: Mania severity score had no significant difference at the beginning of the study, but 4 and 8 weeks after the intervention, it was reduced significantly in both groups (P < 0.001) that was higher in memantine group (P = 0.038). The mean increase in score of cognitive variations was 6.74 in the memantine group and 3.62 in the placebo group with a nonsignificant difference (P = 0.125). The scores of each dimension of QoL in the two groups showed that in all four dimensions, the patient's physical, psychological, social, and environmental status increased significantly by time (P < 0.001). Conclusions: According to the results of this study, memantine as an adjuvant to administration of sodium valproate may have a significant effect on decreasing the intensity of mania in the long run.
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Affiliation(s)
- Victoria Omranifard
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Tarrahi
- Department of Biostatistics and Epidemiology, Faculty of Health, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shima Sharifi
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Karahmadi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Noor Hospital, Isfahan, Iran
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Demontis F, Serra F, Serra G. Antidepressant-induced Dopamine Receptor Dysregulation: A Valid Animal Model of Manic-Depressive Illness. Curr Neuropharmacol 2018; 15:417-423. [PMID: 28503114 PMCID: PMC5405612 DOI: 10.2174/1570159x14666160715165648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/05/2016] [Accepted: 05/24/2016] [Indexed: 11/22/2022] Open
Abstract
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. Methods: We reviewed papers reporting preclinical and clinical studies on the role of DA in the mechanism of action of antidepressant treatments and in the patho-physiology of mood disorders. Results: A number of preclinical and clinical evidence suggests that mania could be associated with an increased DA activity, while a reduced function of this neurotransmission might underlie depression. Chronic treatment with imipramine induces a sensitization of DA D2 receptors in the mesolimbic system, followed, after drug discontinuation, by a reduced sensitivity associated with an increased immobility time in forced swimming test of depression (FST). Blockade of glutamate NMDA receptors by memantine administration prevents the imipramine effect on DA receptors sensitivity and on the FST. Conclusion: We suggest that chronic treatment with antidepressants induces a behavioural syndrome that mimics mania (the sensitization of DA receptors), followed by depression (desensitization of DA receptors and increased immobility time in the FST), i.e. an animal model of bipolar disorder. Moreover the observation that memantine prevents the “bipolar-like” behavior, suggests that the drug may have an antimanic and mood stabilizing effect. Preliminary clinical observations support this hypothesis.
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Affiliation(s)
- Francesca Demontis
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Francesca Serra
- Department of General Psychology, University of Padua, Italy
| | - Gino Serra
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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Duan J, Lao C, Chen J, Pan F, Zhang C, Xu W, Zhou W, Hu J, Shang D, Huang M, Xu Y. Memantine induces manic episode in a 73-year-old patient with vascular neurocognitive disorder: a case report. Neuropsychiatr Dis Treat 2018; 14:1395-1398. [PMID: 29881276 PMCID: PMC5985765 DOI: 10.2147/ndt.s160832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Memantine, an N-methyl-d-aspartate receptor antagonist, is a well-established treatment option for moderate-to-severe cognitive impairment related to Alzheimer disease. Recently, growing evidence has indicated memantine might also be effective in treatment of affective disorders. The common drug-induced adverse events of memantine include confusion, dizziness, drowsiness, headache, insomnia, and agitation. Herein, we presented a case of a 73-year-old female patient with vascular neurocognitive disorder, who developed a manic episode after taking memantine.
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Affiliation(s)
- Jinfeng Duan
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Chengming Lao
- College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.,Yiwu Mental Health Center, Yiwu, People's Republic of China
| | - Jingkai Chen
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Fen Pan
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Chenlin Zhang
- College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Weijuan Xu
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Weihua Zhou
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Jianbo Hu
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Desheng Shang
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China
| | - Manli Huang
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
| | - Yi Xu
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, People's Republic of China.,Brain Research Institute of Zhejiang University, Hangzhou, People's Republic of China
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Demontis F, Serra G. Failure of memantine to “reverse” quinpirole-induced hypomotility. World J Psychiatry 2016; 6:215-220. [PMID: 27354963 PMCID: PMC4919260 DOI: 10.5498/wjp.v6.i2.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/28/2016] [Accepted: 03/16/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate antidepressant-like effect of memantine in a rat model.
METHODS: Male Wistar rats were treated intraperitoneally with either vehicle, memantine (10 mg/kg) or imipramine (20 mg/kg), for 3 wk. Twenty-four hour after the last treatment animals were challenged with quinpirole (0.3 mg/kg s.c.) and tested for motor activity. After 1 h habituation to the motility cages, the motor response was recorded for the following 45-min and the data were collected in 5-min time bins.
RESULTS: As expected, chronic treatment with imipramine potentiated the locomotor stimulant effect of quinpirole. On the contrary, chronic memantine administration failed to induce the behavioral supersensitivity to the dopamine agonist.
CONCLUSION: The results show that memantine, at variance with antidepressant treatments, fails to induce dopaminergic behavioral supersensitivity. This observation is consistent with the results of preclinical and clinical studies suggesting that memantine does not have an acute antidepressant action but does have an antimanic and mood-stabilizing effect.
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Hoeller AA, Costa APR, Bicca MA, Matheus FC, Lach G, Spiga F, Lightman SL, Walz R, Collingridge GL, Bortolotto ZA, de Lima TCM. The Role of Hippocampal NMDA Receptors in Long-Term Emotional Responses following Muscarinic Receptor Activation. PLoS One 2016; 11:e0147293. [PMID: 26795565 PMCID: PMC4721870 DOI: 10.1371/journal.pone.0147293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 01/01/2016] [Indexed: 01/28/2023] Open
Abstract
Extensive evidence indicates the influence of the cholinergic system on emotional processing. Previous findings provided new insights into the underlying mechanisms of long-term anxiety, showing that rats injected with a single systemic dose of pilocarpine—a muscarinic receptor (mAChR) agonist—displayed persistent anxiogenic-like responses when evaluated in different behavioral tests and time-points (24 h up to 3 months later). Herein, we investigated whether the pilocarpine-induced long-term anxiogenesis modulates the HPA axis function and the putative involvement of NMDA receptors (NMDARs) following mAChRs activation. Accordingly, adult male Wistar rats presented anxiogenic-like behavior in the elevated plus-maze (EPM) after 24 h or 1 month of pilocarpine injection (150 mg/kg, i.p.). In these animals, mAChR activation disrupted HPA axis function inducing a long-term increase of corticosterone release associated with a reduced expression of hippocampal GRs, as well as consistently decreased NMDAR subunits expression. Furthermore, in another group of rats injected with memantine–an NMDARs antagonist (4 mg/kg, i.p.)–prior to pilocarpine, we found inhibition of anxiogenic-like behaviors in the EPM but no further alterations in the pilocarpine-induced NMDARs downregulation. Our data provide evidence that behavioral anxiogenesis induced by mAChR activation effectively yields short- and long-term alterations in hippocampal NMDARs expression associated with impairment of hippocampal inhibitory regulation of HPA axis activity. This is a novel mechanism associated with anxiety-like responses in rats, which comprise a putative target to future translational studies.
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Affiliation(s)
- Alexandre A. Hoeller
- Postgraduate Program in Medical Sciences, Center of Health Sciences, University Hospital, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
- Centre for Synaptic Plasticity, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Dorothy Hodgkin Building, Bristol, BS1 3NY, United Kingdom
- * E-mail: (AAH); (TCML)
| | - Ana Paula R. Costa
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
| | - Maíra A. Bicca
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
| | - Filipe C. Matheus
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
| | - Gilliard Lach
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
- Institute of Pharmacology, Innsbruck Medical University, Innsbruck, 6020, Austria
| | - Francesca Spiga
- Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, School of Clinical Sciences, University of Bristol, Dorothy Hodgkin Building, Bristol, BS1 3NY, United Kingdom
| | - Stafford L. Lightman
- Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, School of Clinical Sciences, University of Bristol, Dorothy Hodgkin Building, Bristol, BS1 3NY, United Kingdom
| | - Roger Walz
- Postgraduate Program in Medical Sciences, Center of Health Sciences, University Hospital, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
- Department of Clinical Medicine, Center of Health Sciences, University Hospital, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
| | - Graham L. Collingridge
- Centre for Synaptic Plasticity, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Dorothy Hodgkin Building, Bristol, BS1 3NY, United Kingdom
| | - Zuner A. Bortolotto
- Centre for Synaptic Plasticity, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Dorothy Hodgkin Building, Bristol, BS1 3NY, United Kingdom
| | - Thereza C. M. de Lima
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040–970, Brazil
- * E-mail: (AAH); (TCML)
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