Assessing the Efficacy of Cognitive Enhancers in Electroconvulsive Therapy: A Randomized Controlled Trial of Rivastigmine and Memantine.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Clinical Neuropharmacology Pub Date : 2025-09-01 Epub Date: 2025-08-08 DOI:10.1097/WNF.0000000000000651

Parniyan Molaee, Nafiseh Jahangiri Zarkani, Maria Tavakoli-Ardakani, Seyedeh Morvarid Neishabouri, Fateme Kazemi Khaledi, Alireza Shamsi

{"title":"Assessing the Efficacy of Cognitive Enhancers in Electroconvulsive Therapy: A Randomized Controlled Trial of Rivastigmine and Memantine.","authors":"Parniyan Molaee, Nafiseh Jahangiri Zarkani, Maria Tavakoli-Ardakani, Seyedeh Morvarid Neishabouri, Fateme Kazemi Khaledi, Alireza Shamsi","doi":"10.1097/WNF.0000000000000651","DOIUrl":null,"url":null,"abstract":"Objective: Electroconvulsive therapy (ECT) is an effective treatment for severe psychiatric disorders but is frequently associated with cognitive side effects. This study aimed to evaluate the effects of rivastigmine and memantine on cognitive function following ECT.Methods: In this multicenter, randomized, double-blind, placebo-controlled trial (registration number: IRCT20190119042417N2), 45 patients receiving ECT were allocated equally to rivastigmine, memantine, or placebo groups. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at baseline, week 2, and week 6. Individual slopes of MoCA change over time were computed using simple linear regression, and group-level comparisons were conducted using t tests and adjusted linear models.Results: Patients receiving rivastigmine showed a significantly greater improvement in weekly MoCA scores compared with placebo (mean slope=+0.42 vs. -0.11 points/week; P =0.006; Cohen d=1.40). Memantine was associated with a positive slope (+0.24 points/week), but the effect was not statistically significant after adjusting for baseline cognitive status and covariates.Conclusions: Rivastigmine may enhance cognitive recovery following ECT. Memantine showed a positive but nonsignificant effect. These findings support the potential utility of cholinergic modulation in mitigating ECT-related cognitive deficits. Future research should explore combination therapies and utilize more sensitive, domain-specific cognitive assessments.","PeriodicalId":10449,"journal":{"name":"Clinical Neuropharmacology","volume":" ","pages":"171-178"},"PeriodicalIF":1.5000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/WNF.0000000000000651","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/8 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Electroconvulsive therapy (ECT) is an effective treatment for severe psychiatric disorders but is frequently associated with cognitive side effects. This study aimed to evaluate the effects of rivastigmine and memantine on cognitive function following ECT.

Methods: In this multicenter, randomized, double-blind, placebo-controlled trial (registration number: IRCT20190119042417N2), 45 patients receiving ECT were allocated equally to rivastigmine, memantine, or placebo groups. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at baseline, week 2, and week 6. Individual slopes of MoCA change over time were computed using simple linear regression, and group-level comparisons were conducted using t tests and adjusted linear models.

Results: Patients receiving rivastigmine showed a significantly greater improvement in weekly MoCA scores compared with placebo (mean slope=+0.42 vs. -0.11 points/week; P =0.006; Cohen d=1.40). Memantine was associated with a positive slope (+0.24 points/week), but the effect was not statistically significant after adjusting for baseline cognitive status and covariates.

Conclusions: Rivastigmine may enhance cognitive recovery following ECT. Memantine showed a positive but nonsignificant effect. These findings support the potential utility of cholinergic modulation in mitigating ECT-related cognitive deficits. Future research should explore combination therapies and utilize more sensitive, domain-specific cognitive assessments.

查看原文本刊更多论文

评估电休克治疗中认知增强剂的疗效：一项利瓦斯汀和美金刚的随机对照试验。

目的：电休克治疗是治疗严重精神疾病的有效方法，但常伴有认知方面的副作用。本研究旨在评价利瓦斯汀和美金刚对电痉挛后认知功能的影响。方法：在这项多中心、随机、双盲、安慰剂对照试验（注册号：IRCT20190119042417N2）中，45名接受ECT治疗的患者被平均分配到利瓦斯蒂明、美金刚或安慰剂组。在基线、第2周和第6周使用蒙特利尔认知评估（MoCA）评估认知功能。使用简单线性回归计算MoCA随时间变化的个体斜率，并使用t检验和调整后的线性模型进行组水平比较。结果：与安慰剂相比，接受利瓦斯汀治疗的患者在每周MoCA评分方面的改善明显更大（平均斜率=+0.42 vs -0.11分/周；P=0.006; Cohen d=1.40）。美金刚与正斜率相关（+0.24分/周），但在调整基线认知状态和协变量后，效果无统计学意义。结论：利瓦斯汀可促进电痉挛后的认知恢复。美金刚阳性但不显著。这些发现支持胆碱能调节在减轻ect相关认知缺陷方面的潜在效用。未来的研究应该探索联合疗法，并利用更敏感的、特定领域的认知评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Neuropharmacology 医学-临床神经学

CiteScore

1.20

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.