Bipolar Disorder/Memantine

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Question
Hi Dr. Goldberg,

I was curious if you had ever used Memantine in patients with Bipolar?

I suffer from severe OCD and some variation of Bipolar and have struggled with medication due to a general sensitivity (my psychiatrist believes I might be a slow metabolizer).

I've tried Memantine in doses between 2.5 and 15mg and found it increased my overall anxiety. However, because I have tried so much without success, I'd been wondering whether I might respond to a higher dose (such as the 20mg used in studies). Have you noticed -- or are you otherwise able to speculate on -- whether increased NMDA antagonism might be beneficial in anxiety disorders (where lower levels weren't), or is it too inter-individual to say?

Thank you for your time,
David

Answer
Hi, David . . .

I have prescribed mamantine for about a dozen patients I was treating for bipolar disorder. As you have probably read it has been suggested both as a treatment for cognitive impairment in people with bipolar disorder and as an antimanic agent or mood stabilizer. None of the people with bipolar disorder for whom I prescribed it  reported a significant improvement.

Best regards . . .

Ivan

Bipolar Disorder

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Ivan Goldberg, M.D.

Expertise

I am a psychiatrist/psychopharmacologist with many years of expereince in treating individuals with depressions, manic-depression (Bipolar Disorder), other mood disorders,. I am especially interested in the psychopharmacologic treatment of individuals with so called "treatment-resistant" syndromes.

Experience

I have been on the staff of the National Institute of Mental Health, Columbia's College of Physicians and Surgeons, and the Columbia-Presbyterian Medical Center. I am currently in full-time private practice in New York City.

A.B. Johns Hopkins University
M.D. N.Y.U. College of Medicine

I am the creator of Depression Central:http://www.psycom.net/depression.central.html

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