medigraphic.com
Academia Mexicana de Neurología, A.C.

2016, Number 3

<< Back Next >>

Rev Mex Neuroci 2016; 17 (3)

Effect of memantine on behavior and joint attention in children with autism spectrum disorder

Aguirre-Velázquez CG, Ruelas-Tapia JM, Esquer-Sumuano M

Language: Spanish
References: 19
Page: 60-69
PDF size: 213.23 Kb.


ABSTRACT

Introduction: The autism spectrum disorder (ASD) show symptoms in social interaction, communication, restricted interests and repetitive behaviors. It has proposed a hypothesis of abnormal glutamate to explain the varied symptoms of ASD. Memantine is an intermittent blocker of metyl-ND- aspartate (NMDA) glutamate receptor that may have therapeutic effects in the ASD.
Objective: To demonstrate that memantine has therapeutic effects on abnormal behavior and abilities of joint attention in a group of children with ASD.
Methods: This is a prospective study of 15 children with ASD in an open label clinical trial with memantine for two months. Consistency in treatment, side effects, aggravations and improvements were scored in a survey via email by parents. ABC-C scale to the abnormal behaviors of ASD was applied. Joint attention pre- and post memantine was evaluated in clinical videos.
Results: We recruited a group of 15 children with ASD, 11 male and 4 female, ages 2.6 to 9 years (mean 5.8 years). The parents reported improvement (93% overall) in attention (60%), communication and language (53%) and overall understanding (40%). Reported side effects were mild in 86%. In the ABC-C scale improvement it was observed in 57%. Joint attention ratings showed an average nonsignificant improvement of 0.75 points (p = 0.40).
Conclusions: Memantine has therapeutic effects on abnormal behavior in the ABC-C scale. The task of joint attention pre and post positive difference it was not statistically significant. Memantine is well tolerated by pediatric patients with ASD. We believe that the memantine is a new and useful therapeutic resource in childhood autism and requiring more double-blind studies with placebo.


REFERENCES

  1. Grzadzinski R, Huerta M, Lord C. DSM-5 and autism spectrum disorders (ASDs): an opportunity for identifying ASD subtypes. Mol Autism 2013; 4: 12.

  2. Nazeer A. Psychopharmacology of autistic spectrum disorders in children and adolescents. Pediatric Clinic of North America 2011; 58: 85-97.

  3. McPheeters ML, Warren Z, Sathe N, Bruzek JL, et al. A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics 2011; 127: e1312–e1321.

  4. Carlson GC. Glutamate receptor dysfunction and drug targets across models of autism spectrum disorders. Pharmacology Biochemistry and Behavior 2012; 4: 850–854.

  5. Fatemi SH, Folsom TD, Kneeland RE, Liesch SB. Metabotropic glutamate receptor 5 upregulation in children with autism is associated with underexpression of both Fragile X mental retardation protein and GABAA receptor beta 3 in adults with autism. Anatomical Record (Hoboken) 2011; 294: 1635–1645.

  6. Fatemi SH, Halt AR, Stary JM, Kanodia R, et al. Glutamic acid decarboxylase 65 and 67 kDa proteins are reduced in the autistic parietal and cerebellar cortices. Biological Psychiatry 2002; 52: 805–810.

  7. Laurence JA, Fatemi SH. Glial fibrillary acidic protein is elevated in superior frontal, parietal and cerebellar cortices of autistic subjects. Cerebellum 2005; 4: 206–210.

  8. Carlsson ML. Hypothesis: is infantile autism a hypoglutamatergic disorder? Relevance of glutamate – serotonin interactions for pharmacotherapy. Journal of Neural Transmission 1998; 105: 525–535.

  9. Lipton SA. Failures and successes of NMDA receptor antagonists: molecular basis for the use of open-channel blockers like memantine in the treatment of acute and chronic neurologic insults. NeuroRx 2004; 1: 101–110.

  10. Zdanys K, Tampi RR (2008). A systematic review of off-label uses of memantine for psychiatric disorders. Progress in Neuropsychopharmacology and Biological Psychiatry 2008; 32: 1362–1374.

  11. Chez MG, Burton Q, Dowling T, Chang M, et al. Memantine as adjunctive therapy in children diagnosed with autistic spectrum disorders: an observation of initial clinical response and maintenance tolerability. Journal of Child Neurology 2007; 22: 574–579.

  12. Erickson CA, Posey DJ, Stigler KA, Mullett J, et al. A retrospective study of memantine in children and adolescents with pervasive developmental disorders. Psychopharmacology (Berlin) 2007; 191: 141–147.

  13. Niederhofer H. Glutamate antagonists seem to be slightly effective in psychopharmacologic treatment of autism. Journal of Clinical Psychopharmacology 2007; 27: 317–318.

  14. Owley T, Salt J, Guter S, Grieve A. A prospective, open-label trial of memantine in the treatment of cognitive, behavioral, and memory dysfunction in pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacolology 2006; 16: 517–524.

  15. Ghaleiha A, Asadabadi M, Mohammadi R, Shahei M, Tabrizi M, Hajiaghaee R et al. Memantine as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial. International Journal of Neuropsychopharmacology 2013; 16: 783–789.

  16. Alessandri M, Mundy P, Tuchman RF. Déficit social en el autism: Un enfoque en la atención conjunta. Rev Neurol 2005; 40: S137-S141.

  17. Pinar O, Ozgur O, Kerim M. Three-item Direct Observation Screen (TIDOS) for autism spectrum disorder. Autism 2014; 18: 733-742.

  18. Aman MG, Singh NN, Stewart AW, Field CJ. The aberrant behavior checklist: a behavior rating scale for assessment of treatment effects. American Journal of Mental Deficit 1985; 89: 485-491.

  19. Mundy P, Delgado C, Block J, Venezia M, Hogan A, Seibert J. University of Miami Psychology Department, Coral; Gables, FL: 2003. A manual for the Abridged Early Social Communication Scales (ESCS) Retrieved August 1, 1999 from http://www.psy.miami.edu/faculty/pmundy/main.phtml




2020     |     www.medigraphic.com