{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T01:10:01Z","timestamp":1754010601690,"version":"3.41.2"},"reference-count":10,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>Memantine is a noncompetitive N-methyl-D-aspartate receptor antagonist approved by the FDA for moderate to severe Alzheimer\u2019s dementia. Memantine is also recommended as an off-label treatment in current catatonia clinical guidelines when benzodiazepines alone are inadequate.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Case<\/jats:title>\n<jats:p>A 37-year-old male with a history of schizophrenia on psychiatric conservatorship, stimulant use disorder, and traumatic brain injury was stabilized on risperidone 4 mg twice daily, diphenhydramine 50 mg twice daily, divalproex delayed release 500 mg twice daily, and lorazepam 1 mg twice daily for catatonia. Lorazepam was titrated for unresolved chronic catatonic symptoms but was not tolerated beyond 5 mg total per day due to hemodynamic instability. Owing to barriers in initiating clozapine or electroconvulsive therapy, the patient was started on memantine to address residual catatonia symptoms. After the addition of memantine, the patient began to spontaneously speak in multiple languages and engage in discharge planning, but shortly after a dose increase to 15 mg daily also displayed increased aggressive behaviors. The aggression improved after decreasing the dose to 10 mg daily, and the patient was discharged.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This case adds to the body of evidence for memantine in catatonia with underlying schizophrenia and, to our knowledge, is the first described case of memantine uncovering aggression during catatonia treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.9740\/mhc.2025.08.218","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:30:53Z","timestamp":1754008253000},"page":"218-21","source":"Crossref","is-referenced-by-count":0,"title":["Memantine leading to physical aggression in the treatment of chronic catatonia secondary to schizophrenia: A case report"],"prefix":"10.9740","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8340-2296","authenticated-orcid":true,"given":"Andrew Chantha","family":"Hean","sequence":"first","affiliation":[{"name":"(Corresponding author) Assistant Professor of Pharmacy Practice and Administration, Western University of Health Sciences, College of Pharmacy, Pomona, California, ahean@westernu.edu"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6002-7219","authenticated-orcid":true,"given":"Jessica","family":"Jones","sequence":"additional","affiliation":[{"name":"Behavioral Health Pharmacy Specialist, Department of Pharmacy, Sharp Grossmont Hospital, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4979-0554","authenticated-orcid":true,"given":"Michael","family":"Arena","sequence":"additional","affiliation":[{"name":"Attending Psychiatrist, San Diego County Psychiatric Hospital, County of San Diego Health and Human Services Agency, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-9790","authenticated-orcid":true,"given":"Kevin","family":"Kavanagh","sequence":"additional","affiliation":[{"name":"Clinical Pharmacist, San Diego County Psychiatric Hospital, County of San Diego Health and Human Services Agency, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"key":"i2168-9709-15-4-218-b01","series-title":"Gen Hosp Psychiatry","first-page":"1","article-title":"Alternative treatment strategies for catatonia: a systematic review","volume":"48","author":"Beach","year":"2017","unstructured":"Beach SR,Gomez-Bernal F,Huffman JC,Fricchione GL. Alternative treatment strategies for catatonia: a systematic review. Gen Hosp Psychiatry. 2017;48:1-19. DOI: 10.1016\/j.genhosppsych.2017.06.011"},{"key":"i2168-9709-15-4-218-b02","article-title":"Package insert","author":"Namenda (memantine hydrochloride)","year":"2018","unstructured":"Namenda (memantine hydrochloride). Package insert. Allergan USA, Inc; 2018."},{"issue":"4","key":"i2168-9709-15-4-218-b03","series-title":"J Psychopharmacol (Oxf)","first-page":"327","article-title":"Evidence-based consensus guidelines for the management of catatonia: recommendations from the British Association for Psychopharmacology","volume":"37","author":"Rogers","year":"2023","unstructured":"Rogers JP,Oldham MA,Fricchione G,Northoff G,Wilson JE,Mann SC, et al. Evidence-based consensus guidelines for the management of catatonia: recommendations from the British Association for Psychopharmacology. J Psychopharmacol (Oxf). 2023;37(4):327-69. DOI: 10.1177\/02698811231158232"},{"issue":"2","key":"i2168-9709-15-4-218-b04","series-title":"Ann Clin Psychiatry","first-page":"140","article-title":"Catatonia in the medically ill: etiology, diagnosis, and treatment. The Academy of Consultation-Liaison Psychiatry Evidence-Based Medicine Subcommittee Monograph","volume":"30","author":"Denysenko","year":"2018","unstructured":"Denysenko L,Sica N,Penders TM,Philbrick KL,Walker A,Shaffer S, et al. Catatonia in the medically ill: etiology, diagnosis, and treatment. The Academy of Consultation-Liaison Psychiatry Evidence-Based Medicine Subcommittee Monograph. Ann Clin Psychiatry. 2018;30(2):140-55. PMID: 29697715"},{"key":"i2168-9709-15-4-218-b05","series-title":"Gen Hosp Psychiatry","first-page":"132","article-title":"NMDA antagonists in the treatment of catatonia: A review of case studies from the last 10 years","volume":"51","author":"Theibert","year":"2018","unstructured":"Theibert HPM,Carroll BT. 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Front Behav Neurosci. 2022:16:938044. DOI: 10.3389\/fnbeh.2022.938044"},{"issue":"3","key":"i2168-9709-15-4-218-b08","series-title":"Aggress Behav","first-page":"365","article-title":"Opposing effects of NMDA receptor antagonists on early life stress-induced aggression in mice","volume":"48","author":"Nordman","year":"2022","unstructured":"Nordman JC,Bartsch CJ,Li Z. Opposing effects of NMDA receptor antagonists on early life stress-induced aggression in mice. Aggress Behav. 2022;48(3):365-73. DOI: 10.1002\/ab.22022"},{"issue":"1","key":"i2168-9709-15-4-218-b09","series-title":"J Neuropsychiatry Clin Neurosci","first-page":"e10-3","article-title":"Retrospective study on agitation provoked by memantine in dementia","volume":"27","author":"Da Re","year":"2015","unstructured":"Da Re F,Rucci F,Isella V. Retrospective study on agitation provoked by memantine in dementia. J Neuropsychiatry Clin Neurosci. 2015;27(1):e10-3. 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