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KMID : 0605720070130010062
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Journal of the Korean Society of Biological Therapies in Psychiatry
2007 Volume.13 No. 1 p.62 ~ p.74
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The Effect of Memantine Administration on Serum Total Antioxidant Capacity in Dementia of the Alzheimer’s Type
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Cheon Jin-Sook
Kim In-Seong
Oh Byoung-Hoon
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Abstract
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Objectives : Memantine is a low to moderate affinity, uncompetitive N-methyl-D-aspartate(NMDA) receptor antagonist, which has been used to treat patients with moderate to severe dementia of the Alzheimer’s type. A few animal studies suggest a mechanism related to oxidative stress may be involved in the effect of memantine. The aims of this study are to evaluate whether administration of memantine causes change in a peripheral blood marker of oxidative stress, which may provide a clinical evidence of oxidative stress hypothesis, to identify influencing factors, and to suggest a peripheral blood marker of oxidative stress can be used to measure the effect of memantine in clinical practice.
Methods : The subjects were consisted with 66 patients(19 males and 47 females) admitted to the Gongju geriatric hospital from early January in 2006 thru the end of August in 2006 under the diagnosis of probable dementia of the Alzheimer’s type according to the DSM-IV and the NINCDS-ADRDA criteria. The control group was consisted with 60 healthy elderly(18 males and 42 females) who were compatible with sex, age and educational level of patient group. The demographic data were obtained by structured interviews. The cognitive disorder was assessed by the MMSE-K, severity of dementia by the CDR and the GDS, and function by the ADL. The serum total antioxidant capacity(TAC) was measured by chemiluminescence method, once in the control group and three times(before memantine administration, 1 month after memantine administration and 2 months after memantine administration) in the patient group.
Results : 1) As compared with TAC before memantine administration(1.762±0.133m㏖/L), TAC(2.096±0.172 m㏖/L) increased significantly at 2 months after memantine administration(p＜0.001), which was significantly (p＜0.001, respectively) higher than TAC at 1 month after memantine administration(1.865±0.283m㏖/L) and TAC of normal aged controls(1.935±0.194m㏖/L). 2) The TAC of controls was significantly different according to age, educational levels and MMSE-K scores(p＜0.001, respectively). The TAC of patient group was significantly different according to MMSE-K scores(p＜0.005), CDR(p＜0.05), GDS(p＜0.05) and ADL(p＜0.005) before memantine administration, according to sex(p＜0.05) and age(p＜0.05) at 1 month after memantine administration, and according to ADL(p＜0.05) at 2 months after memantine administration. 3) The effect of mematine administration on the TAC correlated significantly with sex, age and duration of dementia(p＜0.05, respectively) at 1 month after memantine administration, so did with severity of de entia(CDR and GDS, p＜0.05 respectively) and function(ADL, p＜0.05) at 2 months after memantine administration.
Conclusion : To evaluate effect of memantine treatment on patients with moderate to severe dementia of the Alzheimer’s type, a peripheral blood marker of oxidative stress seemed to be preferable to clinical scales.
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KEYWORD
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NMDA receptor antagonist, Memantine, Moderate to severe dementia of the Alzheimer’s type, Oxidative stress, Total antioxidant capacity
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