ABSTRACT

Background: Currently, there is a paucity of pharmacological treatment options for posttraumatic stress disorder (PTSD), and the development of a novel pharmacotherapeutic approach has become a matter of great interest.

Objective: We conducted a 12-week open-label clinical trial to examine the efficacy and safety of memantine, an N-methyl-D-aspartate receptor antagonist, in the treatment of civilian PTSD.

Method: Thirteen adult patients with DSM-IV PTSD, all civilian women, were enrolled. They were monitored at an ambulatory care facility every week until 4 weeks and then every 4 weeks until 12 weeks. Memantine was added to each patient’s current medication, with the initial dosage of 5 mg/day and then titrated. Concomitant medications were essentially kept unchanged during the trial. The primary outcome was PTSD diagnosis and severity assessed with the Posttraumatic Diagnostic Scale (PDS).

Results: Of the 13 cases, one dropped out and two were discarded due to the protocol deviation, and the analysis was done for the remaining 10. Mean PDS total scores decreased from 32.3 ± 9.7 at baseline to 12.2 ± 7.9 at endpoint, which was statistically significant with a large effect (paired t-test: p = .002, d = 1.35); intrusion, avoidance, hyperarousal symptoms were all significantly improved from baseline to endpoint. Six patients no longer fulfilled the diagnostic criteria of PTSD at endpoint. Some adverse, but not serious, effects possibly related to memantine were observed, including sleep problems, sleepiness, sedation, weight change and hypotension.

Conclusions: Memantine significantly reduced PTSD symptoms in civilian female PTSD patients and the drug was well tolerated. Future randomized controlled trials are necessary to verify the efficacy and safety of memantine in the treatment of PTSD.

摘要

背景：目前，创伤后应激障碍 (PTSD) 缺乏药物治疗选择，开发新的药物治疗方法已成为人们非常感兴趣的问题。

目的：我们进行了一项为期 12 周的开放标签临床试验，以检查美金刚（一种N-甲基-D-天冬氨酸受体拮抗剂）治疗平民 PTSD的有效性和安全性。

方法：招募了 13 名患有 DSM-IV PTSD 的成年患者，全部为平民女性。他们每周在门诊护理机构接受监测，直至 4 周，然后每 4 周监测一次，直至 12 周。美金刚被添加到每位患者目前的药物中，初始剂量为 5 毫克/天，然后滴定。在试验期间，伴随用药基本保持不变。主要结果是 PTSD 诊断和使用创伤后诊断量表 (PDS) 评估的严重程度。

结果：在 13 例中，1 例中途退出，2 例因协议偏差而被丢弃，并对其余 10 例进行分析。平均 PDS 总分从基线时的 32.3 ± 9.7 下降到终点时的 12.2 ± 7.9，这是具有大效应的统计显着性（配对t检验：p = .002，d = 1.35）；从基线到终点，侵入、回避、过度唤醒症状都有显着改善。6 名患者在终点不再满足 PTSD 的诊断标准。观察到一些可能与美金刚相关的不利但不严重的影响，包括睡眠问题、嗜睡、镇静、体重变化和低血压。

结论：美金刚显着减轻了平民女性 PTSD 患者的 PTSD 症状，并且药物耐受性良好。未来有必要进行随机对照试验来验证美金刚治疗 PTSD 的有效性和安全性。