Journal of American Science2013;9(10s) http://www.jofamericanscience.org 71 The efficacy of complementary use of memantine in treatment of schizophrenia with chronic course Ali Fakhari 1 , Sepideh Herizchi 1 , Mohamad Goldust 1 , Ashkan yousefi Jafarabadi 1 Tabriz University of Medical Sciences, Tabriz, Iran fakharia@tbzmed.ac.ir Abstract: Memantine, a drug approved by the FDA for the treatment of moderate to severe Alzheimer's disease, acts as a weak nonselective NMDA receptor antagonist. This study aimed at evaluating the efficacy of complementary use of memantine in treatment of schizophrenia with chronic course. This clinical trial study was conducted on 60 patients with chronic schizophrenia Diagnosis was established using DSM-IV criteria. The antipsychotic medication dose was kept constant for at least six weeks before entry and throughout the entire study period. Memantine was started on day one at a single morning dose of 5 mg, as add-on to antipsychotic drugs. Dose was titrated weekly by 5 mg, up to 20 mg dose at eighths week. Clinical assessments were performed monthly, using the Positive and Negative Syndrome Scale (PANSS). Participants comprised of chronic schizophrenia. Mean age of the study patients was 44.15 ± 9. 65 years. Memantine and adding it to the consumption of other antipsychotic drugs had not any significant effect on Positive and Negative scale. In the total score of PANASS in three levels of evaluation, there was no significant different between two groups which represent that adding memantine to risperidone had not any significant effect on Positive and Negative scale, combination one and general pathology. Memantine add-on to risperidone therapy was not associated with improvement in negative and positive symptoms in refractory schizophrenia patients. [Ali Fakhari , Sepideh Herizchi, Mohamad Goldust, Ashkan yousefi Jafarabadi. The efficacy of complementary use of memantine in treatment of schizophrenia with chronic course. J Am Sci 2013;9(10s):71-74]. (ISSN: 1545-1003). http://www.jofamericanscience.org . 13 Keywords: Schizophrenia; Memantine; Treatment 1. Introduction Schizophrenia is a mental disorder characterized by a breakdown of thought processes and by a deficit of typical emotional responses. Common symptoms are delusions and disorganized thinking including auditory hallucinations, paranoia, bizarre delusions, disorganized speech, and it is accompanied by significant social or occupational dysfunction.(de et al. 2013; Kishi and Iwata 2013) The onset of symptoms typically occurs in young adulthood, with a global lifetime prevalence of about 0.3–0.7%. Diagnosis is based on observed behavior and the patient's reported experiences. It's not known what causes schizophrenia, but researchers believe that a combination of genetics and environment contributes to development of the disease. (Kotermanski et al. 2013; Rezaei et al. 2013) Problems with certain naturally occurring brain chemicals, including the neurotransmitters dopamine and glutamate, also may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't certain about the significance of these changes, they support evidence that schizophrenia is a brain disease.(Uribe et al. 2013; Pae 2013) The primary treatment of schizophrenia is antipsychotic medications, often in combination with psychological and social supports. Hospitalization may occur for severe episodes either voluntarily or involuntarily. Long-term hospitalization is uncommon since deinstitutionalization beginning in the 1950s, although it still occurs.(Sekar et al. 2013; Sani et al. 2012) Community support services including drop-in centers, visits by members of a community mental health team, supported employment and support groups are common. Some evidence indicates that regular exercise has a positive effect on the physical and mental health of those with schizophrenia.(Lee et al. 2012; Pohanka 2012) Phospholipid metabolism occurs in cell membranes and although regional differences are described by Jensen et al., these are not neurotransmitter-specific. This research suggests increased phospholipid metabolism in the anterior cingulate area of people with schizophrenia. Previous studies suggest that this is supportive evidence for a neurodegenerative mechanism in schizophrenia. They also review the effects of neuroleptic and anxiolytic medications on brain phosphorus metabolism.(de et al. 2012; Namba et al. 2011) Memantine is a drug currently licensed for use in people with moderate to severe Alzheimer’s dementia. It is a non-competitive, low-affinity N-methyl-D-aspartate (NMDA) antagonist. Glutamate-mediated excitotoxicity and/or receptor dysfunction is involved in the pathogenesis of several neuropsychiatric and neurological disorders. Memantine partially blocks these NMDA receptors, preventing a neurotoxic influx of calcium.