Demo Chapter – Pharmacological Treatments, Continued Copy

Pharmacological Treatments, Continued (4, 5, 6)

NMDA Antagonists:

• Agonists of the glutamate N-methyl-d-aspartate receptor.
• Indicated when other treatments fail or can’t be used.
• Amantadine or memantine are options if benzodiazepines or ECT were not effective.

• Dose, route, and frequency:
  • Amantadine: 100mg daily titrated up to a max daily dose of 500mg given in 2-3 divided doses.
    • Can be given in oral or parenteral formulation in same dose range.
  • Memantine: daily dose of 10mg given orally.
    • Max daily dose of 20mg.

• Length of therapy and response:
  • Response to NMDA antagonists is generally seen within one day, with complete remission of symptoms within three weeks.
  • The effects are slower with NMDA antagonists compared to lorazepam.