N-methyl-d-aspartate (NMDA) receptor antagonists for treatment of catatonia in adults: Narrative review.
Jeong Hoo Lee, Joji Suzuki
General Hospital Psychiatry 2024 DOI: 10.1016/j.genhosppsych.2024.09.005 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Case report Peer reviewed |
|---|---|
| Population | Adults with catatonia |
| Interventions | Amantadine Memantine Ketamine Esketamine |
| Topics | Esketamine Ketamine |
| Keywords | Amantadine Memantine Nmda receptor antagonists Catatonia treatment Psychiatric medications Movement disorders Neurological breakthroughs |
| Citations | 4 |
| Key findings | NMDA receptor antagonists, particularly amantadine and memantine, may be effective alternatives for treating catatonia in adults who do not respond to benzodiazepines or ECT. |
Abstract
While the majority of patients with catatonia fully respond to benzodiazepines or ECT, some have a partial or no response. Benzodiazepines may be contraindicated such as when delirium co-exists. This review discusses the utility of NMDA receptor antagonists as alternatives to benzodiazepines in the treatment of catatonia in adults. A PubMed search adhering to PRISMA guidelines was conducted for articles on NMDA receptor antagonists in catatonia treatment. Thirty-seven articles, including case reports and case series were identified. Amantadine (27 cases in 13 articles) and memantine (20 cases in 14 articles) were the most commonly reported agents. Amantadine, typically used as monotherapy or adjunctive therapy with benzodiazepines, showed quick responses. Memantine, used alone or with lorazepam, demonstrated rapid responses. A small number of cases (5 cases in 4 articles) reported successful use of ketamine and esketamine, highlighting their potential role in catatonia treatment. Despite limitations, NMDA receptor antagonists may be viable options when the patient is partially or not responsive to benzodiazepine, ECT is not available or may not be well tolerated, there is a concern for co-morbid delirium where benzodiazepines may be contraindicated. Further research is needed.
Comparable studies
Other narrative reviews on esketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Long-term safety of ketamine and esketamine in treatment of depression | 2022 | Review | |
| Ketamine, Esketamine, and Arketamine: Their Mechanisms of Action and Applications in the Treatment of Depression and Alleviation of Depressive Symptoms. | 2024 | Review | |
| The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence. | 2023 | Review | |
| Variations in BDNF and Their Role in the Neurotrophic Antidepressant Mechanisms of Ketamine and Esketamine: A Review. Patients with depression | 2024 | Narrative review |
Citations in the library
Cites 7
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- Association of Ketamine With Psychiatric Symptoms and Implications for Its Therapeutic Use and for Understanding Schizophrenia JAMA Network Open May 1, 2020
- The Therapeutic Effects of Ketamine in Mental Health Disorders: A Narrative Review Cureus March 30, 2022
- Ketamine as an alternative to ECT in catatonia in elderly women with bipolar disorder: A case report. Frontiers in Psychiatry 2023
and 2 more in the library