Erickson Craig A, Posey David J, Stigler Kimberly A, Mullett Jennifer, Katschke Adrian R, McDougle Christopher J
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Psychopharmacology (Berl). 2007 Mar;191(1):141-7. doi: 10.1007/s00213-006-0518-9. Epub 2006 Oct 3.
There are no drugs that have been shown to effectively treat the core social impairment of autism.
The purpose of this study was to examine the effectiveness and tolerability of memantine for social impairment in children and adolescents with pervasive developmental disorders (PDDs).
Medical records of 18 patients with PDDs consecutively treated with open-label memantine were retrospectively reviewed. The data reviewed included prospectively obtained assessments of severity (S) and improvement (I) using the Clinical Global Impressions Scale (CGI). Pretrial and follow-up parent ratings were also available on six patients using the Aberrant Behavior Checklist (ABC).
Eighteen patients (15 male, 3 female; mean age=11.4 years, range 6-19 years) received memantine (mean dosage=10.1 mg/day, range 2.5-20 mg/day) over a mean duration of 19.3 weeks (range 1.5-56 weeks). Eleven of 18 (61%) patients were judged responders to memantine based on a rating of "much improved" or "very much improved" on the CGI-I. Significant improvement was also seen on the CGI-S. Improvement was primarily seen clinically in social withdrawal and inattention. Adverse effects occurred in 7 of 18 (39%) patients and led to drug discontinuation in 4 of 18 (22%) patients. Thirteen of 18 (72%) patients received stable doses of concomitant medications during the memantine trial.
In this open-label retrospective study, memantine was effective in a number of patients with PDDs. Controlled studies are warranted to further assess the efficacy and safety of memantine in PDDs.
尚无药物被证明能有效治疗自闭症的核心社交障碍。
本研究旨在检验美金刚对广泛性发育障碍(PDD)儿童和青少年社交障碍的有效性和耐受性。
回顾性分析18例接受开放性美金刚治疗的PDD患者的病历。所回顾的数据包括使用临床总体印象量表(CGI)对严重程度(S)和改善情况(I)进行的前瞻性评估。还对6例患者使用异常行为检查表(ABC)进行了治疗前和随访时家长评分。
18例患者(15例男性,3例女性;平均年龄 = 11.4岁,范围6 - 19岁)接受了美金刚治疗(平均剂量 = 10.1毫克/天,范围2.5 - 20毫克/天),平均疗程为19.3周(范围1.5 - 56周)。根据CGI - I量表上“明显改善”或“非常明显改善”的评分,18例患者中有11例(61%)被判定为美金刚治疗有效。CGI - S量表也显示出显著改善。临床上主要在社交退缩和注意力不集中方面有改善。18例患者中有7例(39%)出现不良反应,其中4例(22%)患者因不良反应停药。在美金刚试验期间,18例患者中有13例(72%)接受了稳定剂量的伴随药物治疗。
在这项开放性回顾性研究中,美金刚对一些PDD患者有效。有必要进行对照研究以进一步评估美金刚在PDD中的疗效和安全性。