Rajabi Fatemeh, Fozveh Fatemeh, Maracy Mohammad Reza
Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Psychiatry. 2023 Jul;18(3):266-274. doi: 10.18502/ijps.v18i3.13003.
Studies using standard neuropsychological instrumentation have shown memory deficits in posttraumatic stress disorder (PTSD) patients. We examined the efficacy and safety of memantine in new cases of combat-related PTSD in the military by conducting a 16-week prospective double-blind randomized controlled trial. Twenty-six new combat-related PTSD cases were recruited from among the military personnel based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Patients were assigned to memantine and Placebo groups. They were monitored at baseline, week eight, and week 16. Memantine was added to each patient's current medication with an initial dosage of 5 mg/day, raised by 5 mg/day every week until it reached the maintenance level of 20 mg/day. The concurrent drugs were essentially kept unchanged during the trial. The primary outcome was PTSD severity as assessed by the Clinician-administered PTSD Scale (CAPS). The CAPS is a valid and reliable tool for the diagnosis of PTSD and measurement of its severity according to the DSM-4. CAPS mean score in baseline (P = 0.811) and weeks eight (P = 0.389) and 16 (P = 0.066) did not show any significant differences between the two groups. The mean CAPS score in the memantine group significantly (P = 0.006) decreased (Mean differences = -8.79) compared to the placebo group, showing that intervention with memantine was effective. The mean total CAPS in weeks eight (Mean differences = -14.21) and 16 (Mean differences = -27) were less than the baseline, which was significantly meaningful (P < 0.001). Findings of this study suggest that add-on memantine can be effective in veteran patients with PTSD. So our data provide useful insight into the management of new cases of combat-related PTSD.
使用标准神经心理学检测手段的研究表明，创伤后应激障碍（PTSD）患者存在记忆缺陷。我们通过开展一项为期16周的前瞻性双盲随机对照试验，研究了美金刚对军队中与战斗相关的新发PTSD病例的疗效和安全性。根据《精神疾病诊断与统计手册》第五版（DSM - 5），从军事人员中招募了26例与战斗相关的新发PTSD病例。患者被分为美金刚组和安慰剂组。在基线、第8周和第16周对他们进行监测。美金刚以5毫克/天的初始剂量添加到每位患者当前的药物治疗中，每周增加5毫克/天，直至达到20毫克/天的维持剂量。在试验期间，同时使用的其他药物基本保持不变。主要结局是由临床医生评定的PTSD量表（CAPS）评估的PTSD严重程度。CAPS是一种根据DSM - 4诊断PTSD及其严重程度的有效且可靠的工具。两组在基线时（P = 0.811）、第8周时（P = 0.389）和第16周时（P = 0.066）的CAPS平均得分均未显示出任何显著差异。与安慰剂组相比，美金刚组的CAPS平均得分显著降低（P = 0.006）（平均差异=-8.79），表明美金刚干预有效。第8周时（平均差异=-14.21）和第16周时（平均差异=-27）的CAPS总分均值低于基线，具有显著意义（P < 0.001）。本研究结果表明，加用美金刚对患有PTSD的退伍军人可能有效。因此，我们的数据为与战斗相关的新发PTSD病例的管理提供了有用的见解。
