title: Memantine for late-life depression and apathy after a disabling medical event: a 12-week, double-blind placebo-controlled pilot study.
abstract: OBJECTIVE
  Preclinical data suggests that memantine, a noncompetitive glutamate N-methyl- D-aspartate-receptor blocker used for the treatment of moderate to severe Alzheimer's disease, could reduce depressive and amotivated behavior occurring in the context of psychosocial stress. Therefore, we examined whether memantine could reduce depressive symptoms and amotivation manifesting in older adults after a disabling medical event, thereby improving their functional recovery.
  
  
  METHODS
  We recruited subjects aged 60 years and older who had recently suffered a disabling medical event and were admitted to a skilled nursing facility for rehabilitation. Participants with significant depressive symptoms, defined as a Hamilton Rating Scale for Depression score of 10 or greater, and/or significant apathy symptoms, defined as an Apathy Evaluation Scale score of 40 or greater, were randomized to memantine (10 mg/d for 1 week, then 10 mg twice daily) or placebo, for 12 weeks. We also recruited participants without depressive or apathy symptoms for naturalistic follow-up as a non-depressed comparison group. Depressive and apathy symptoms were main outcomes; functional recovery, and self-report rating of helplessness, and onset of new depressive disorders were secondary outcomes.
  
  
  RESULTS
  Thirty-five older adults with significant depressive and/or apathy symptoms were randomized, of whom 27 (77.1%) completed the 12 week randomized controlled trial. Both groups showed reduction in depressive symptoms (but no significant reduction in apathy symptoms) and improved function. However, there were no group differences between the memantine-randomized and placebo randomized participants on any outcome.
  
  
  CONCLUSIONS
  Memantine was not associated with superior affective or functional outcome compared with placebo in medically rehabilitating older adults with depressive and apathy symptoms.
authors.affiliation: Department of Psychiatry, Washington University, St. Louis, MO, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Skidmore
authors.forename: Amy E
authors.initials: AE
authors.lastname: Begley
authors.forename: John W
authors.initials: JW
authors.lastname: Newcomer
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Whyte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D057565:Apathy / Q000187:drug effects*; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales
chemical_list: D000928:Antidepressive Agents; D018691:Excitatory Amino Acid Antagonists; D008559:Memantine