Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions

Veronese, Nicola; Solmi, Marco; Luchini, Claudio; Lu, Ru Band; Stubbs, Brendon; Zaninotto, Leonardo; Correll, Christoph U.

doi:10.1016/j.jad.2016.03.034

Cited by 17 publications

(8 citation statements)

References 56 publications

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“…Likewise, previous preclinical reported data demonstrated that the association of MEM with antidepressant drugs, such as fluoxetine and venlafaxine enhances the antidepressant effect of classical therapies. MEM associated with galantamine was investigated in the treatment of cognitive deficits in with schizophrenia [ 120, 121 ]. Others clinical trial evaluated, a part of MEM, additional non-pharmacological strategies for example the Environmental Ecological Therapy in AD [ 122, 123 ].…”

Section: Clinical Trials With Memantinementioning

confidence: 99%

Memantine for the Treatment of Dementia: A Review on its Current and Future Applications

Folch

Busquets

Ettcheto

et al. 2018

JAD

182

107

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Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by the presence in the brain of extracellular amyloid-β protein (Aβ) and intracellular neurofibrillary tangles composed of hyperphosphorylated tau protein. The N-Methyl-D-aspartate receptors (NMDAR), ionotropic glutamate receptor, are essential for processes like learning and memory. An excessive activation of NMDARs has been associated with neuronal loss. The discovery of extrasynaptic NMDARs provided a rational and physiological explanation between physiological and excitotoxic actions of glutamate. Memantine (MEM), an antagonist of extrasynaptic NMDAR, is currently used for the treatment of AD jointly with acetylcholinesterase inhibitors. It has been demonstrated that MEM preferentially prevents the excessive continuous extrasynaptic NMDAR disease activation and therefore prevents neuronal cell death induced by excitotoxicity without disrupting physiological synaptic activity. The problem is that MEM has shown no clear positive effects in clinical applications while, in preclinical stages, had very promising results. The data in preclinical studies suggests that MEM has a positive impact on improving AD brain neuropathology, as well as in preventing Aβ production, aggregation, or downstream neurotoxic consequences, in part through the blockade of extrasynaptic NMDAR. Thus, the focus of this review is primarily to discuss the efficacy of MEM in preclinical models of AD, consider possible combinations of this drug with others, and then evaluate possible reasons for its lack of efficacy in clinical trials. Finally, applications in other pathologies are also considered.

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Section: Clinical Trials With Memantinementioning

confidence: 99%

Memantine for the Treatment of Dementia: A Review on its Current and Future Applications

Folch

Busquets

Ettcheto

et al. 2018

JAD

182

107

View full text Add to dashboard Cite

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“…The analysis of the data concerning the usefulness of the cholinesterase inhibitors galantamine and donepezil as well as the glutamate receptor antagonist memantine was negative (Veronese et al, 2016). …”

Section: Efficacy Datamentioning

confidence: 99%

“…Finally, a meta-analysis reported that the probability of receiving placebo, baseline illness severity, and trial duration correlate with placebo response rates and/or clinical trial outcome in RCTs of pharmacotherapy for bipolar depression (Nierenberg et al, 2015), while another one was negative concerning the usefulness of galantamine, donepezil, and memantine (Veronese et al, 2016). …”

Section: Efficacy Datamentioning

confidence: 99%

The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

Fountoulakis

Yatham

Grunze

et al. 2016

IJNPPY

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Background:The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety.Material and Methods:The PRISMA method was used in the literature search with the combination of the words ‘bipolar,’ ‘manic,’ ‘mania,’ ‘manic depression,’ and ‘manic depressive’ with ‘randomized,’ and ‘algorithms’ with ‘mania,’ ‘manic,’ ‘bipolar,’ ‘manic-depressive,’ or ‘manic depression.’ Relevant web pages and review articles were also reviewed.Results:The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice.Conclusions:A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses.

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“…In line with results for unipolar depression (Reynolds 2011), a recent review in mainly working-age adults shows that acetylcholinesterase inhibitors (AChEIs) are not helpful in reducing mood or psychotic symptoms in bipolar depression and mania (Veronese 2016). However, the review reports on only three randomised controlled trials (RCTs) of AChEIs.…”

Section: Acetylcholinesterase Inhibitors and Memantinementioning

confidence: 94%

Understanding and managing cognitive impairment in bipolar disorder in older people

2019

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SUMMARYBipolar disorder is less prevalent in older people but accounts for 8–10% of psychiatric admissions. Treating and managing bipolar disorder in older people is challenging because of medical comorbidity. We review the cognitive problems observed in older people, explore why these are important and consider current treatment options. There are very few studies examining the cognitive profiles of older people with bipolar disorder and symptomatic depression and mania, and these show significant impairments in executive function. Most studies have focused on cognitive impairment in euthymic older people: as in euthymic adults of working age, significant impairments are observed in tests of attention, memory and executive function/processing speeds. Screening tests are not always helpful in euthymic older people as the impairment can be relatively subtle, and more in-depth neuropsychological testing may be needed to show impairments. Cognitive impairment may be more pronounced in older people with ‘late-onset’ bipolar disorder than in those with ‘early-onset’ disorder. Strategies to address symptomatic cognitive impairment in older people include assertive treatment of the mood disorder, minimising drugs that can adversely affect cognition, optimising physical healthcare and reducing relapse rates.LEARNING OBJECTIVESAfter reading this article you will be able to: •understand that cognitive impairment in euthymic older people with bipolar disorder is similar to that in working-age adults with the disorder, affecting attention, memory and executive function/processing speeds•recognise that cognitive impairment in older people is likely to be a major determinant of functional outcomes•Implement approaches to treat cognitive impairment in bipolar disorder.DECLARATION OF INTERESTB.J.S. consults for Cambridge Cognition, PEAK (www.peak.net) and Mundipharma.

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Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions

Abstract: Background

Cited by 17 publications

References 56 publications

Memantine for the Treatment of Dementia: A Review on its Current and Future Applications

Memantine for the Treatment of Dementia: A Review on its Current and Future Applications

The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

Understanding and managing cognitive impairment in bipolar disorder in older people

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