TY - JOUR
T1 - Memantine add-on to antipsychotic treatment for residual negative and cognitive symptoms of schizophrenia
T2 - a meta-analysis
AU - Kishi, Taro
AU - Matsuda, Yuki
AU - Iwata, Nakao
N1 - Funding Information:
Dr. Kishi has received speaker’s honoraria from Daiichi Sankyo, Dainippon Sumitomo, Eisai, Eli Lilly, Janssen, Otsuka, Meiji, MSD, Tanabe-Mitsubishi (Yoshitomi), and Pfizer, and has a Fujita Health University School of Medicine research grant.
Publisher Copyright:
© 2017, Springer-Verlag Berlin Heidelberg.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Rationale: We examined whether memantine add-on to antipsychotic treatment is beneficial in schizophrenia treatment. Objective: This systematic review and meta-analysis aimed to achieve stronger evidence on the efficacy and safety of memantine add-on for treating schizophrenia. Methods: We analyzed double-blind, randomized, placebo-controlled trials of memantine add-on treatment in schizophrenia patients receiving antipsychotics. The primary outcomes were amelioration of negative symptoms and all-cause discontinuation. Dichotomous outcomes are presented as risk ratios (RRs), and continuous outcomes are presented as mean differences (MDs) or standardized mean differences (SMDs). Results: Eight studies (n = 448) were included. Although memantine add-on treatment was superior to placebo for ameliorating negative symptoms (SMD = −0.96, p = 0.006, I2 = 88%; N = 7, n = 367) in the Positive and Negative Syndrome Scale general subscale (MD = −1.62, p = 0.002, I2 = 0%; N = 4, n = 151) and Mini-Mental Status Examination score (MD = −3.07, p < 0.0001, I2 = 21%; N = 3, n = 83), there were no statistically significant differences in the amelioration of overall (SMD = −0.75, p = 0.06, I2 = 86%; N = 5, n = 271), positive (SMD = −0.46, p = 0.07, I2 = 80%; N = 7, n = 367), and depressive symptoms (SMD = −0.127, p = 0.326, I2 = 0%; N = 4, n = 201); all-cause discontinuation (RR = 1.34, p = 0.31, I2 = 0%; N = 8, n = 448); and individual adverse events (fatigue, dizziness, headache, nausea, constipation) between the groups. For negative symptoms, the significant heterogeneity disappeared when risperidone studies alone were considered (I2 = 0%). However, memantine add-on treatment remained superior to placebo (SMD = −1.29, p = 0.00001). Meta-regression analysis showed that patient age was associated with memantine-associated amelioration of negative symptoms (slope = 0.171, p = 0.0206). Conclusions: Memantine add-on treatment may be beneficial for treating psychopathological symptoms (especially negative symptoms) in schizophrenia patients. The negative-symptom effect size may be associated with younger adult schizophrenia patients.
AB - Rationale: We examined whether memantine add-on to antipsychotic treatment is beneficial in schizophrenia treatment. Objective: This systematic review and meta-analysis aimed to achieve stronger evidence on the efficacy and safety of memantine add-on for treating schizophrenia. Methods: We analyzed double-blind, randomized, placebo-controlled trials of memantine add-on treatment in schizophrenia patients receiving antipsychotics. The primary outcomes were amelioration of negative symptoms and all-cause discontinuation. Dichotomous outcomes are presented as risk ratios (RRs), and continuous outcomes are presented as mean differences (MDs) or standardized mean differences (SMDs). Results: Eight studies (n = 448) were included. Although memantine add-on treatment was superior to placebo for ameliorating negative symptoms (SMD = −0.96, p = 0.006, I2 = 88%; N = 7, n = 367) in the Positive and Negative Syndrome Scale general subscale (MD = −1.62, p = 0.002, I2 = 0%; N = 4, n = 151) and Mini-Mental Status Examination score (MD = −3.07, p < 0.0001, I2 = 21%; N = 3, n = 83), there were no statistically significant differences in the amelioration of overall (SMD = −0.75, p = 0.06, I2 = 86%; N = 5, n = 271), positive (SMD = −0.46, p = 0.07, I2 = 80%; N = 7, n = 367), and depressive symptoms (SMD = −0.127, p = 0.326, I2 = 0%; N = 4, n = 201); all-cause discontinuation (RR = 1.34, p = 0.31, I2 = 0%; N = 8, n = 448); and individual adverse events (fatigue, dizziness, headache, nausea, constipation) between the groups. For negative symptoms, the significant heterogeneity disappeared when risperidone studies alone were considered (I2 = 0%). However, memantine add-on treatment remained superior to placebo (SMD = −1.29, p = 0.00001). Meta-regression analysis showed that patient age was associated with memantine-associated amelioration of negative symptoms (slope = 0.171, p = 0.0206). Conclusions: Memantine add-on treatment may be beneficial for treating psychopathological symptoms (especially negative symptoms) in schizophrenia patients. The negative-symptom effect size may be associated with younger adult schizophrenia patients.
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U2 - 10.1007/s00213-017-4616-7
DO - 10.1007/s00213-017-4616-7
M3 - Article
C2 - 28508107
AN - SCOPUS:85019216501
SN - 0033-3158
VL - 234
SP - 2113
EP - 2125
JO - Psychopharmacology
JF - Psychopharmacology
IS - 14
ER -