Improvement in Memory Deficits With Memantine in Mania Secondary to Traumatic Brain Injury and Preexisting Perinatal Birth Injury.

Cognitive deficits are known to occur after brain injury, be it perinatal injury, traumatic brain injury (TBI), or any other type of insult to the brain. The problem may be compounded if psychiatric illness is present in addition to the brain injury because the illness itself or the psychotropic medications used in its management may lead to worsening of cognitive functioning. We present the case of a patient who presented to the hospital with symptoms suggestive of mania with psychotic features that had started after a recent TBI, with the brain scan also revealing the presence of a preexisting perinatal birth injury. When the patient recovered from the psychiatric symptoms, he still appeared to have memory problems that improved with the use of add-on memantine, an N-methyl-D-aspartate receptor antagonist. To date, there is some literature supporting the off-label use of memantine as a cognitive enhancer in patients with TBIs and other psychiatric illnesses, such as bipolar disorder.