Catatonia Delirium: 3 Cases Treated With Memantine

Roy, Kamalika; Warnick, Stephen J.; Balon, Richard

doi:10.1016/j.psym.2016.08.001

Cited by 21 publications

(11 citation statements)

References 13 publications

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“…In anti-NMDA receptor encephalitis, antibodies to the NMDA receptors induce internalizations of the NMDA receptors, causing a progressive but reversible loss of surface NMDA receptors and leading to reduced function of NMDA receptors [ 21 ]. It was reported that memantine is effective in treating catatonia symptoms in schizophrenia and depression [ 77 , 78 , 79 ]. Interestingly, it was pointed out that catatonia may arise from NMDA receptor hyperfunction, although there is an apparent contradiction to catatonia symptoms seen in patients with anti-NMDA receptor encephalitis and to the NMDA receptor hypofunction hypothesis in schizophrenia [ 80 ].…”

Section: Can Memantine Ameliorate Abnormalities Caused By Other Nmmentioning

confidence: 99%

Is Memantine Effective as an NMDA Receptor Antagonist in Adjunctive Therapy for Schizophrenia?

Kikuchi

2020

Biomolecules

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Memantine, an n-methyl-d-aspartate (NMDA) receptor antagonist approved for treating Alzheimer’s disease, has a good safety profile and is increasingly being studied for possible use in a variety of non-dementia psychiatric disorders. There is an abundance of basic and clinical data that support the hypothesis that NMDA receptor hypofunction contributes to the pathophysiology of schizophrenia. However, there are numerous randomized, double-blind, placebo-controlled clinical trials showing that add-on treatment with memantine improves negative and cognitive symptoms, particularly the negative symptoms of schizophrenia, indicating that memantine as adjunctive therapy in schizophrenia helps to ameliorate negative symptoms and cognitive deficits. It remains unclear why memantine does not show undesirable central nervous system (CNS) side effects in humans unlike other NMDA receptor antagonists, such as phencyclidine and ketamine. However, the answer could lie in the fact that it would appear that memantine works as a low-affinity, fast off-rate, voltage-dependent, and uncompetitive antagonist with preferential inhibition of extrasynaptic receptors. It is reasonable to assume that the effects of memantine as adjunctive therapy on negative symptoms and cognitive deficits in schizophrenia may derive primarily, if not totally, from its NMDA receptor antagonist activity at NMDA receptors including extrasynaptic receptors in the CNS.

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Section: Can Memantine Ameliorate Abnormalities Caused By Other Nmmentioning

confidence: 99%

Is Memantine Effective as an NMDA Receptor Antagonist in Adjunctive Therapy for Schizophrenia?

Kikuchi

2020

Biomolecules

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“…However, these syndromes are not necessarily mutually exclusive. Given that both hyperactive and hypoactive delirium share motor features that overlap with catatonia, a catatonic subtype of delirium has been described in the literature [ 15 ], alternatively conceptualized as cooccurring delirium and catatonia [ 16 – 18 ], with descriptions of cases treated with memantine and ECT [ 17 , 19 ]. The presence of suspected NMS in our patient further complicated his diagnosis, given that NMS often presents with features of catatonia and has previously been considered as a subtype of malignant catatonia [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

The Treatment of Clozapine-Withdrawal Delirium with Electroconvulsive Therapy

Modak

Åhlin

2017

Case Reports in Psychiatry

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Clozapine, a commonly used atypical antipsychotic, can precipitate a severe withdrawal syndrome. In this report, we describe a case of delirium with catatonic features emerging after the immediate cessation of clozapine subsequent to concerns of developing neuroleptic malignant syndrome. After multiple treatments were found to be inefficacious, electroconvulsive therapy (ECT) was initiated, resulting in significant improvement. A literature search revealed six previous cases of clozapine-withdrawal syndromes of varied symptomatology treated with ECT. To our knowledge, the present case represents the first reported clozapine-withdrawal delirium treated successfully with ECT.

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“…There are few reported cases where memantine was successfully used to treat catatonia, these cases were frequently associated with schizophrenia, also named catatonic schizophrenia (Thomas et al, 2005;Carpenter et al, 2006;Mukai et al, 2011;Obregon et al, 2011;Roy et al, 2016).…”

Section: Amantadine and Nmdar Antagonistsmentioning

confidence: 99%

“…This diminishes RS production, avoiding cellular apoptosis and dysfunction (de Lucena et al, 2012 ; Fryml et al, 2017 ). Furthermore, by reducing excitotoxicity, it can in turn compensate GABA A hypofunction at the mesostriatal circuit and reduce dopamine uptake at the synaptic cleft (Northoff et al, 1997 ; Roy et al, 2016 ).…”

Section: Revisiting Current Therapeuticsmentioning

confidence: 99%

Molecular and cellular mechanisms leading to catatonia: an integrative approach from clinical and preclinical evidence

Ariza-Salamanca

Corrales-Hernández

Pachón-Londoño

et al. 2022

Front. Mol. Neurosci.

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This review aims to describe the clinical spectrum of catatonia, in order to carefully assess the involvement of astrocytes, neurons, oligodendrocytes, and microglia, and articulate the available preclinical and clinical evidence to achieve a translational understanding of the cellular and molecular mechanisms behind this disorder. Catatonia is highly common in psychiatric and acutely ill patients, with prevalence ranging from 7.6% to 38%. It is usually present in different psychiatric conditions such as mood and psychotic disorders; it is also a consequence of folate deficiency, autoimmunity, paraneoplastic disorders, and even autistic spectrum disorders. Few therapeutic options are available due to its complexity and poorly understood physiopathology. We briefly revisit the traditional treatments used in catatonia, such as antipsychotics, electroconvulsive therapy, and benzodiazepines, before assessing novel therapeutics which aim to modulate molecular pathways through different mechanisms, including NMDA antagonism and its allosteric modulation, and anti-inflammatory drugs to modulate microglia reaction and mitigate oxidative stress, such as lithium, vitamin B12, and NMDAr positive allosteric modulators.

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Catatonia Delirium: 3 Cases Treated With Memantine

Cited by 21 publications

References 13 publications

Is Memantine Effective as an NMDA Receptor Antagonist in Adjunctive Therapy for Schizophrenia?

Is Memantine Effective as an NMDA Receptor Antagonist in Adjunctive Therapy for Schizophrenia?

The Treatment of Clozapine-Withdrawal Delirium with Electroconvulsive Therapy

Molecular and cellular mechanisms leading to catatonia: an integrative approach from clinical and preclinical evidence

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