Grant Jon E, Odlaug Brian L, Mooney Marc, O'Brien Robert, Kim Suck Won
Department of Psychiatry, University of Minnesota, School of Medicine, Minneapolis, MN 55454, USA.
Ann Clin Psychiatry. 2012 May;24(2):119-26.
Although compulsive buying (CB) is relatively common, pharmacotherapy research for CB is limited. Memantine, an N-methyl-D-aspartate receptor antagonist, appears to reduce glutamate excitability and improve impulsive behaviors, suggesting it may help individuals with CB.
Nine patients (8 females) with CB were enrolled in a 10-week open-label treatment study of memantine (dose ranging from 10 to 30 mg/d). Participants were enrolled from December 2008 until May 2010. The primary outcome measure was change from baseline to study endpoint on the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV).
Of the 9 participants, 8 (88.9%) completed the 10-week study. Y-BOCS-SV scores decreased from a mean of 22.0 ± 1.3 at baseline to 11.0 ± 5.3 at endpoint (P < .001). Hours spent shopping per week and money spent shopping both decreased significantly (P < .001). The mean effective dose of memantine was 23.4 ± 8.1 mg/d. Memantine treatment was associated with diminished impulsive buying and improvements on cognitive tasks of impulsivity. In addition, the medication was well-tolerated.
These findings suggest that pharmacologic manipulation of the glutamate system may target the impulsive behavior underlying CB. Placebo-controlled, double-blind studies are warranted in order to confirm these preliminary findings in a controlled design.
尽管强迫性购物（CB）相对常见，但针对CB的药物治疗研究有限。美金刚，一种N-甲基-D-天冬氨酸受体拮抗剂，似乎能降低谷氨酸兴奋性并改善冲动行为，这表明它可能对患有CB的个体有帮助。
9名患有CB的患者（8名女性）参加了一项为期10周的美金刚开放标签治疗研究（剂量范围为10至30毫克/天）。参与者于2008年12月至2010年5月入组。主要结局指标是耶鲁-布朗强迫量表-购物版（Y-BOCS-SV）从基线到研究终点的变化。
9名参与者中，8名（88.9%）完成了为期10周的研究。Y-BOCS-SV评分从基线时的平均22.0±1.3降至终点时的11.0±5.3（P<.001）。每周购物时间和购物花费均显著减少（P<.001）。美金刚的平均有效剂量为23.4±8.1毫克/天。美金刚治疗与强迫性购物减少以及冲动性认知任务的改善有关。此外，该药物耐受性良好。
这些发现表明，对谷氨酸系统进行药物调控可能针对CB潜在的冲动行为。有必要进行安慰剂对照的双盲研究，以便在对照设计中证实这些初步发现。
