Memantine appeared to be effective and safe for the treatment of autism spectrum disorder (ASD) and/or obsessive-compulsive disorder (OCD) among children and adolescents. These findings were published in Contemporary Clinical Trials Communications.
Data for this analysis were sourced from the Glutamatergic medication in the treatment of Obsessive Compulsive Disorder and Autism Spectrum Disorder (GOAT) substudy which was an exploratory trial within the Translational Adolescent and Childhood Therapeutic Interventions in Compulsive Syndromes (TACTICS) study. Patients (N=7) with ASD and/or OCD were randomly assigned after a 2-week wash-out period in a 1:1 ratio to receive 10 weeks of 5-15 mg/d memantine (n=4) or placebo (n=3). During the 10 weeks, the first 2 to 3 weeks were an up-titration period and weeks 9 and 10 were a down-titration period.
The primary outcomes were change in Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Clinical Global Impression-Improvement (CGI-I), and Children’s Global Assessment (C-GAS) scores and safety was measured using the Pediatric Adverse Event Rating Scale (PAERS) instrument.
The patient cohort included 4 girls and 3 boys aged 6 to 17 years, 4 had OCD, 2 had ASD, 1 had comorbid OCD and ASD, 2 patients were recruited in London, England, 2 in Mannheim, Germany, and in Nijmegen, Netherlands, respectively. Patients randomly assigned to receive memantine were all using concomitant sertraline, and 1 was also using melatonin. Two of the patients randomly assigned to placebo used no concomitant medications and 1 used risperidone, melatonin, and methylphenidate.
The memantine cohort were found to have CY-BOCS score decreases between 19.2% to 42.9% compared with the change in scores among the placebo group of 0% to 14.3%. CGI-I scores were much improved, minimally improved, and minimally worse among the memantine group and minimally improved and no change among the placebo group. The average change in C-GAS scores were 9.5 and 5.0 points for the memantine and placebo recipients, respectively.
A total of 163 adverse events were recorded using PAERS. The adverse events were drug-related for 20.2%, among which 66.7% were reported by memantine recipients and 33.3% by placebo recipients. The most common drug-related events were sedation (18.2%) and stomachache (15.2%), which were reported by a single patient each. No serious events were reported and no drug discontinuations due to adverse events occurred.
Study authors noted that the memantine recipients lost 1.2-5.5 kg while the placebo recipients gained 0.3-2.9 kg.
This study was limited by its small sample size and by the fact that 1 participant in each group withdrew from the study early.
Study authors concluded, “Our findings, although based on a very small number of patients and therefore insufficient to draw clear conclusions, appear to be in line with the hypothesis that memantine is an effective, tolerable and safe agent for children and adolescents with ASD and/or OCD. […] In accordance with previous findings, our study supports the perception that treatment with memantine in children and adolescents is well tolerated and safe; no serious adverse events (SAEs) or discontinuations due to AEs occurred in our study population.”
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Niemeyer L, Mechler K, Dittmann RW, et al. Memantine as treatment for compulsivity in child and adolescent psychiatry: descriptive findings from an incompleted randomized, double-blind, placebo controlled trial. Contemp Clin Trials Commun. 2022;100982. doi:10.1016/j.conctc.2022.100982