title: Effect of Memantine on Cognitive Performance in Patients Under Electroconvulsive Therapy: A Double-Blind Randomized Clinical Trial.
abstract: OBJECTIVE
  Various strategies such as adding cholinesterase inhibitors are used to reduce cognitive impairments during electroconvulsive therapy. In this study, we aimed to assess the effectiveness and safety of memantine as an N-methyl-D-aspartate receptor antagonist in the prevention of cognitive deficits due to ECT.
  
  
  METHODS
  Thirty-eight adult patients with various mental disorders were randomized to memantine (10 mg/day initially and 20 mg/day at the end of the first week) or placebo during the ECT period. Mini Mental Status Examination, Digit Span Subtest, and backward memory span of Wechsler Adult Intelligence Scale were used to assess the cognitive functions 24 hours before and after ECT. Subjective ratings of side effects were obtained in the first, second, and fourth week of the treatment.
  
  
  RESULTS
  The mean Mini Mental Status Examination score relatively increased in the intervention group showing a significant improvement with memantine (P < 0.001). The direct digit span had decreased in the control group, whereas no significant change was observed in the intervention group (P < 0.001). Backward memory span test showed a decrease in the control group after the ECT sessions, whereas a relative increase was observed in the intervention group (P = 0.001). The most frequently reported side effects in the intervention group did not differ significantly from the control group.
  
  
  CONCLUSIONS
  This initial study showed that cognitive performance was enhanced in patients receiving memantine during ECT, indicating the possible role of the glutamatergic system in creating ECT-induced deficits. Larger long-term studies are necessary for understanding the role of the glutamatergic system in these disorders.
authors.affiliation: *Department of Psychiatry, Social Determinants of Health Research Center; †Department of Psychiatry, ‡Department of Physiology and Pharmacology, §Health Management Deputy of Research, and ∥Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
authors.forename: Narges Shams
authors.initials: NS
authors.lastname: Alizadeh
authors.forename: Azad
authors.initials: A
authors.lastname: Maroufi
authors.forename: Mehnoosh
authors.initials: M
authors.lastname: Jamshidi
authors.forename: Kambiz
authors.initials: K
authors.lastname: Hassanzadeh
authors.forename: Fardin
authors.initials: F
authors.lastname: Gharibi
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Ghaderi
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018691:Excitatory Amino Acid Antagonists; D008559:Memantine