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Şizofreni Hastalarında Antipsikotik Tedavinin Memantin ile Güçlendirilmesi: Bir Sistematik Gözden Geçirme ve Metaanaliz

Sefa VAYISOĞLU, Sevilay KARAHAN, A. Elif ANIL YAĞCIOĞLU
2019; 30(4): 253-259
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SUMMARY
Augmentation of Antipsychotic Treatment with Memantine in Patients with Schizophrenia: A Systematic Review and Meta-Analysis

Objective: Many patients with schizophrenia respond partially
to treatment with antipsychotic medications. A wide range of
pharmaceutical agents are utilized as augmentation therapy in order to
increase the efficacy of antipsychotic medication treatment. Memantine
which is a noncompetitive N-methyl-D-aspartate (NMDA) receptor
antagonist is one such agent among these. In this study, by conducting
a systematic review and meta-analysis we aimed to assess the efficacy
of memantine augmentation on psychopathology in patients with
schizophrenia receiving antipsychotic medication.
Method: We analyzed double-blind, randomized, placebo-controlled
trials of memantine add-on treatment in schizophrenia patients
receiving antipsychotic medications. The primary outcome measure was
amelioration of negative symptoms and the secondary outcome measures
were amelioration of positive, total and general psychopathology
symptoms. Publication bias was evaluated by Funnel plot and Egger
test.
Results: Eleven studies (n=570) were included. Although memantine
add-on treatment was superior to placebo for ameliorating negative
symptoms (SMD=0.596, 95% CI=0.075-1.118, p=0.025), there were
no statistically significant differences in the amelioration of general
psychopathology (SMD=0.034, 95% CI=0.419-0.488, p=0.883),
positive (SMD=-0.041, 95% CI=0.217-0.135, p=0.650) and overall
(SMD=0.315, 95% CI=0.256-0.887, p=0.280) symptoms. No
publication bias was observed between studies according to Funnel plots
and Egger test results.
Conclusion: Memantine augmentation treatment seems to be beneficial
for particularly treating negative symptoms in schizophrenia patients.
Further studies with larger sample size and longer follow-up durations
are needed.
Key Words: Memantine, schizophrenia, augmentation treatment