Improvement of negative and positive symptoms in treatment-refractory schizophrenia: a double-blind, randomized, placebo-controlled trial with memantine as add-on therapy to clozapine.

@article{DeLucena2009ImprovementON,
  title={Improvement of negative and positive symptoms in treatment-refractory schizophrenia: a double-blind, randomized, placebo-controlled trial with memantine as add-on therapy to clozapine.},
  author={David De Lucena and Brisa Fernandes and Michael Berk and Seetal Dodd and Dalton Wiggers Medeiros and Mariana Pedrini and Maur{\'i}cio Kunz and Fabiano Alves Gomes and L Giglio and Maria Ines R. Lobato and Paulo S Belmonte-de-Abreu and Clarissa Severino Gama},
  journal={The Journal of clinical psychiatry},
  year={2009},
  volume={70 10},
  pages={
          1416-23
        }
}
BACKGROUND Glutamate deregulation may be involved in the neuropathology of schizophrenia, mainly through N-methyl-d-aspartate (NMDA) receptor dysfunction. Memantine, a drug approved by the FDA for the treatment of moderate to severe Alzheimer's disease, acts as a weak nonselective NMDA receptor antagonist. The aim of this study was to examine the efficacy of memantine as an adjunctive treatment to clozapine in patients with refractory schizophrenia. METHOD In this double-blind, placebo… 
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TLDR
This study shows that, add-on memantine would be helpful, in the adjunctive treatment of depressive, positive, negative and general symptoms in patients with schizophrenia.
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TLDR
Adjunctive memantine treatment did not improve cognitive functioning or affect psychopathology in patients with chronic schizophrenia in the present study, but Memantine was tolerated well and did not exacerbate positive symptoms in patientsWith chronic schizophrenia.
Adjunctive memantine in clozapine-treated refractory schizophrenia: an open-label 1-year extension study
TLDR
In the 1-year extension phase the favourable effect of adjunctive memantine on memory was sustained and the authors observed further improvement of negative, positive and overall symptoms in patients with clozapine-treated refractory schizophrenia.
Critics on "Adjunctive Memantine Therapy for Cognitive Impairment in Chronic Schizophrenia: A Placebo-Controlled Pilot Study"
  • C. Pae
  • Psychology, Medicine
    Psychiatry investigation
  • 2013
TLDR
This study is the first one directly digging out the possible superiority of memantine augmentation over placebo in Asian patients with chronic schizophrenia, deserving add-up of more information for future studies.
Pharmacological interventions in clozapine-refractory schizophrenia
TLDR
Further research on memantine as clozapine augmentation strategy in patients suffering from treatment-resistant schizophrenia is justified.
Adjunctive memantine for schizophrenia: a meta-analysis of randomized, double-blind, placebo-controlled trials
TLDR
This meta-analysis showed that adjunctive memantine appears to be an efficacious and safe treatment for improving negative symptoms and neurocognitive performance in schizophrenia.
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