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Memantine Rescues Neurosyphilis-Related Schizophrenic-like Features and Cognitive Deficit

Chen, Wen-Chien MD*; Wang, Hui-Yi MD*†‡; Chen, Po-An MD*; Chen, I-Chia MS*; Chen, Yi-Chyan MD, PhD*†

doi: 10.1097/WNF.0000000000000347
Case Reports
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Objectives Neurosyphilis, an infectious neuroinflammatory disorder, could cause diverse neuropsychiatric symptoms mimicking disorders of schizophrenia and dementia; hence, it is known as the “chameleon of psychiatry.” Here, we present a subject with neurosyphilis with schizophrenic features and share the treatment outcome.

Methods A 42-year-old single man had schizophrenic-like features and cognitive dysfunction for 1 year. Neurosyphilis was confirmed by a cerebral spinal fluid study. The brain image revealed multiple punctuated white matter gliosis in the bilateral frontal lobes and old lacunar infarctions in the bilateral basal hippocampus. The neuropsychiatric functions were declined until adjunctive memantine therapy.

Results With the add-on therapy of memantine 10 mg daily, the psychotic and dementic symptoms markedly improved, and the patient recovered to the premorbid state in the 2-year follow-up course.

Conclusions Memantine has an adjunctive effect on neurosyphilis-related neuropsychiatric disorder via modulation of the glutamatergic neurotransmission and microglia-induced neuroinflammation.

*Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City;

Department of Psychiatry, School of Medicine, Tzu Chi University, Hualien; and

International Intercollegiate PhD Program, National Tsing Hua University, Hsinchu, Taiwan.

Address correspondence and reprint requests to Yi-Chyan Chen, MD, PhD, Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 289 Jianguo Road, Xindian District, New Taipei City 231, Taiwan; E-mail: yichyanc@gmail.com; yichyanc@tzuchi.com.tw

Conflicts of Interest and Source of Funding: This work was supported by the Taipei Tzu Chi Hospital (TCRD-TPE-106-RT-10), Taiwan. The authors have no conflicts of interest to declare.

Online date: May 23, 2019

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