Research paperEffect of memantine on C-reactive protein and lipid profiles in bipolar disorder

- CRP could be a sensitive marker to discriminate metabolic disturbance in BD patients.
- CRP level stratify metabolic outcome in BD received memantine add-on treatment.
- Add-on memantine reduced inflammation and metabolic disturbances in BD with high CRP.

BackgroundBalance in the immune system plays roles in bipolar disorder (BD) and its metabolic co-morbidities. Memantine is an NMDA receptor antagonist with anti-inflammatory effects. However, the effects of memantine adjunct treatment on metabolic status of BD are unclear.MethodsDuring the 12 weeks period, a total of 191 BD patients were enrolled and split into valproate (VPA) + placebo and VPA + memantine (5 mg/day) arms. The fasting plasma levels of high-sensitivity C-reactive protein (CRP) and metabolic indices were assessed. BD patients were stratified according to their initial CRP level.ResultsA cut-off value of initial CRP level of 2322 ng/mL discriminated the waist circumference in these BD patients after 12-week VPA treatment. In the high CRP (> 2322 ng/mL) group, patients in the VPA + memantine arm had a significantly decreased in their CRP (p= 0.009), total cholesterol (p= 0.002), LDL (p= 0.002) levels, BMI (p= 0.001), and waist circumference (p< 0.001), compared to those in the VPA + placebo arm. However, analysis of the low CRP group did not showed the effect.LimitationsWe recruited BD patients in depressed states and the sample size was relative small. The effects of the fixed dose of memantine on metabolic indices were 12-week follow up in BD patients treated with VPA.ConclusionsBD patients with high initial CRP levels receiving memantine adjunct treatment have a reduced risk of inflammation and metabolic imbalance. Prospective studies are needed to confirm the long-term outcome for memantine adjunct therapy in BD patients.