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Adjunctive memantine for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials
Zheng W.1; Li X.-H.2,3; Yang X.-H.1; Cai D.-B.4; Ungvari G.S.5,6; Ng C.H.7; Wang S.-B.8; Wang Y.-Y.8; Ning Y.-P.1; Xiang Y.-T.8
Source PublicationPsychological Medicine
ISSN14698978 00332917
Other Abstract

Background. Dysfunction of N-methyl-D-aspartate receptor (NMDAR) is involved in the pathophysiology of schizophrenia. A meta-analysis of randomized controlled trials (RCTs) was conducted to examine the efficacy and safety of memantine, a non-competitive NMDAR antagonist, in the treatment of schizophrenia.

Methods. Standardized/weighted mean differences (SMDs/WMDs), risk ratio (RR), and their 95% confidence intervals (CIs) were calculated and analyzed.

Results. Included in the meta-analysis were eight RCTs (n = 452) of 11.5 ± 2.6 weeks duration, with 229 patients on memantine (20 mg/day) and 223 patients on placebo. Adjunctive memantine outperformed placebo in the measures of Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale negative symptoms [SMD: −0.63 (95% CI −1.10 to −0.16), p = 0.009, I 2 = 77%], but not in the total, positive and general symptoms [SMD: −0.46 to −0.08 (95% CI −0.93 to 0.22), p = 0.06–0.60, I 2 = 0–74%] or the Clinical Global Impression Severity Scale [WMD: 0.04 (95% CI −0.24 to 0.32), p = 0.78]. The negative symptoms remained significant after excluding one outlying RCT [SMD: −0.41 (95% CI −0.72 to −0.11), p = 0.008, I 2 = 47%]. Compared with the placebo group, adjunctive memantine was associated with significant improvement in neurocognitive function using the Mini-Mental State Examination (MMSE) [WMD: 3.09, (95% CI 1.77–4.42), p < 0.00001, I 2 = 22%]. There was no significant difference in the discontinuation rate [RR: 1.34 (95% CI 0.76–2.37), p = 0.31, I 2 = 0%] and adverse drug reactions between the two groups.

Conclusions. This meta-analysis showed that adjunctive memantine appears to be an efficacious and safe treatment for improving negative symptoms and neurocognitive performance in schizophrenia. Higher quality RCTs with larger samples are warranted to confirm these findings.

KeywordMemantine Meta-analysis Negative Symptoms Nmda Receptor Antagonists Schizophrenia
URLView the original
Indexed BySSCI
WOS Research AreaPsychology ; Psychiatry
WOS SubjectPsychology, Clinical ; Psychiatry ; Psychology
WOS IDWOS:000418321200008
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Cited Times [WOS]:9   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Corresponding AuthorXiang Y.-T.
Affiliation1.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
2.The National Clinical Research Center for Mental Disorders, China
3.Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
4.Clinics of Chinese Medicine, the First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
5.The University of Notre Dame Australia/Marian Centre, Perth, Australia
6.School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
7.Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
8.Faculty of Health Sciences, Unit of Psychiatry, University of Macau, Macao SAR, China
Corresponding Author AffilicationFaculty of Health Sciences
Recommended Citation
GB/T 7714
Zheng W.,Li X.-H.,Yang X.-H.,et al. Adjunctive memantine for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials[J]. Psychological Medicine,2018,48(1):72-81.
APA Zheng W..,Li X.-H..,Yang X.-H..,Cai D.-B..,Ungvari G.S..,...&Xiang Y.-T..(2018).Adjunctive memantine for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials.Psychological Medicine,48(1),72-81.
MLA Zheng W.,et al."Adjunctive memantine for schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials".Psychological Medicine 48.1(2018):72-81.
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