Is anti-NMDA receptor encephalitis real? II. Therapeutic challenges
- Authors: Snedkov E.V.1, Volchek I.A.2,3, Lemeshev I.V.1,4
-
Affiliations:
- Psychiatric Hospital of St. Nicolas Wonderworker
- Federal State Budgetary Educational Institution of Higher Education Russian Biotechnological University
- Research Center for Immunology and Allergology
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol LVI, No 1 (2024)
- Pages: 83-94
- Section: Discussions
- URL: https://journals.rcsi.science/1027-4898/article/view/256811
- DOI: https://doi.org/10.17816/nb624112
- ID: 256811
Cite item
Abstract
The first part of the review challenges the diagnostic concept of anti-NMDA receptor encephalitis (ANMDARE). The second part focuses on analyzing current therapeutic approaches. It is demonstrated that the use of antipsychotics or immunosuppressants poses the risk of severe complications, potentially leading to fatal outcomes, in the near or distant future. Comparing clinical and neurobiological effects associated with antibodies to the GluN1 subunit of the glutamate N-methyl-D-aspartate receptors (NMDAR1-AB) and the administration of subanesthetic doses of the non-competitive NMDA receptor antagonist Ketamine highly suggests a neuroprotective, health-promoting role of NMDAR1-AB, which should not be suppressed but rather potentiated. Benzodiazepines and electroconvulsive therapy (ECT) remain the treatment of choice for acute polymorphic hyperkinetic psychoses.
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##article.viewOnOriginalSite##About the authors
Evgeny V. Snedkov
Psychiatric Hospital of St. Nicolas Wonderworker
Email: esnedkov@mail.ru
ORCID iD: 0000-0002-1438-1890
SPIN-code: 4353-6428
MD, Dr. Sci. (Med.), Professor
Russian Federation, St. PetersburgIgor A. Volchek
Federal State Budgetary Educational Institution of Higher Education Russian Biotechnological University; Research Center for Immunology and Allergology
Email: igor.volchek@gmail.com
ORCID iD: 0009-0000-1451-6145
SPIN-code: 6743-2105
д-р мед. наук, профессор; главный научный сотрудник научно-исследовательского центра иммунологии и аллергологии
Russian Federation, Moscow; MoscowIlia V. Lemeshev
Psychiatric Hospital of St. Nicolas Wonderworker; North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: ilya.lemeshev@gmail.com
ORCID iD: 0009-0002-0491-6545
SPIN-code: 7635-4548
MD, Head of the Day Hospital Department, Psychiatrist; Assistant Professor
Russian Federation, St. Petersburg; St. PetersburgReferences
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