Memantine may acutely improve cognition and have a mood stabilizing effect in treatment-resistant bipolar disorder

Abstract

The patients described in this report used medications that could cause cognitive impairment. Memantine could have antagonized these effects, through unclear mechanisms.To our knowledge, this is the first report on the usefulness of memantine in the treatment of cognitive impairment in bipolar disorder patients. Randomized double-blind controlled studies are needed to validate these preliminary observations.

Chronic Administration of Valproic Acid Reduces Brain NMDA Signaling via Arachidonic Acid in Unanesthetized Rats

“…Thus, reduced NMDA signaling involving AA and its metabolites may be common to the therapeutic action of mood-stabilizers in bipolar disorder. Evidence that cholinomimetics [19] as well as drugs that interfere with dopaminergic [24,60,68,71] or glutamatergic [2,61,88] signaling ameliorate bipolar disorder symptoms, and of defective serotonergic signaling in the disease [56], has suggested that bipolar symptoms reflect reduced cholinergic, altered serotonergic, and increased dopaminergic and glutamatergic neurotransmission. Our studies in rats now suggest that chronic VPA, lithium and carbamazepine as a group can correct this imbalance, and that the imbalance involves AA as a second messenger [4-9, 21, 77].…”

Memantine-Related Psychotic Symptoms in a Patient With Bipolar Disorder

“…4,5 In a few case reports, memantine was found to be useful in treatment-resistant bipolar disorder. 9,10 However, our patient developed delusions and auditory hallucinations shortly after beginning memantine therapy. The strict temporal relationship between the use of the drug and the onset of the psychotic symptoms, as well as the resolution once treatment was discontinued, suggests a causal link between the two phenomena.…”

Add-on Memantine Treatment for a Complicated Case of Juvenile Bipolar Mood Disorder with Co-morbid Obsessive-compulsive Disorder

“…It was suggested that memantine by blocking NMDA receptors prevents the up and down regulation of mesolimbic dopamine D2 receptors and the neurodegeneration that results from excessive glutamatergic neurotransmission during mania which might underlie the following depressive phase [7]. Importantly, memantine would expectedly be of help mitigating the cognitive problems incurred by the disorder itself [31,32] and negative impact of psychotropic drugs in this student due to its cognitive enhancer activity resonating with reports of using it as add-on with stimulants in adult ADHD [13] and as an effective monotherapy in paediatric ADHD too [33]. Dosing of memantine in this case was similar to that of AD, that is, 20 mg divided on 2 doses and escalated over 4 weeks.…”