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Acute effects of memantine in combination with alcohol in moderate drinkers

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Abstract

Rationale

Alcohol effects in humans involve N-methyl-d-aspartate (NMDA) receptor-mediated glutamatergic neurotransmission. It has been proposed that NMDA receptor antagonists may be effective in the treatment of alcohol dependence.

Objective

This study evaluated the acute effects of memantine, an NMDA receptor antagonist, on the subjective, physiological, and performance effects of alcohol in moderate (10–30 drinks per week) alcohol drinkers.

Methods

Eighteen volunteers without alcohol dependence were tested using a double-blind design with three 3-day long inpatient phases separated by at least a 2-week wash-out period. Memantine (0, 15, and 30 mg) was administered 4 h before alcohol (1.5 g/l body water), which was given in four divided doses every 20 min.

Results

Pretreatment with memantine attenuated the craving for alcohol before alcohol administration, but not after alcohol was given. Memantine increased the dissociative effects of alcohol, without altering its sedative, stimulant, and overall intoxicating effects. Memantine also did not affect alcohol-induced impairment in performance, physiological changes, or pharmacokinetics. Memantine increased subjective reports of dissociation, confusion, and stimulation, and impaired motor coordination on the balance task.

Conclusions

Memantine was well tolerated in combination with alcohol. The findings suggest that NMDA receptor neurotransmission may be involved in alcohol craving and alcohol-induced subjective dissociative effects.

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Acknowledgements

This work was supported by research grants from the National Institute of Alcohol Abuse and Alcoholism (AA12599) to Dr. Evans, the National Institute of Drug Abuse to Dr. Bisaga (K23 DA00429), and the National Institute of Mental Health to Dr. Papp (MH 61274). Portions of the data contained in this manuscript were presented at the 24th Annual Meeting of the Research Society on Alcoholism, Montreal, Canada, 2001. The authors thank Dr. Richard Foltin for help in analyzing data, Drs. Meg Haney and Wojciech Danysz for reviewing the manuscript, Dr. Laszlo Papp for the use of the research unit, and Beth Fishbein, Jordyn Conrad and Charise Freundlich for their help in conducting this research.

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Correspondence to Adam Bisaga.

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Bisaga, A., Evans, S.M. Acute effects of memantine in combination with alcohol in moderate drinkers. Psychopharmacology 172, 16–24 (2004). https://doi.org/10.1007/s00213-003-1617-5

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