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美金刚可减少偷窃癖的偷窃行为和冲动:一项初步研究。

Memantine reduces stealing behavior and impulsivity in kleptomania: a pilot study.

机构信息

Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois 60637, USA.

出版信息

Int Clin Psychopharmacol. 2013 Mar;28(2):106-11. doi: 10.1097/YIC.0b013e32835c8c8c.

DOI:10.1097/YIC.0b013e32835c8c8c
PMID:23299454
Abstract

Kleptomania is characterized by repetitive stealing behavior and has been associated with deleterious unwanted outcomes including forensic contact and increased rates of suicidal behavior. Very few trials have been conducted to investigate pharmacological treatment options for this neglected condition. Memantine is an NMDA-receptor antagonist that has shown promising results in the treatment of other behavioral addictions and substance addictions. Twelve individuals with kleptomania received memantine (10 mg/day, titrated to 30 mg/day maximum depending on clinical response and tolerability) over the course of 8 weeks, in an open-label trial. The effects of treatment were quantified using well-validated measures and select neurocognitive tests (last observation carried forward analyses). Kleptomania disease severity scores decreased across all measures considered, and 11 (91.7%) of the participants met the responder criteria (35% improvement on the primary effectiveness measure plus CGI improved/very much improved; significant improvements were also observed in terms of mood, anxiety, and disability scores along with a significant improvement in stop-signal response inhibition. Memantine was generally well tolerated. This study shows the effectiveness of memantine in reducing urges to shoplift and shoplifting behavior along with improving impulsivity, mood, anxiety, and psychosocial functioning.

摘要

偷窃癖的特征是反复出现的偷窃行为,并与有害的不良后果有关,包括法律纠纷和自杀行为发生率的增加。很少有试验研究过治疗这种被忽视的疾病的药物治疗选择。美金刚是一种 NMDA 受体拮抗剂,在治疗其他行为成瘾和物质成瘾方面显示出了有希望的结果。12 名患有偷窃癖的患者在 8 周的时间内接受了美金刚(10mg/天,根据临床反应和耐受性滴定至最大 30mg/天)治疗,这是一项开放标签试验。使用经过充分验证的措施和选择神经认知测试(最后观察到的向前分析)来量化治疗效果。在所有考虑的措施中,偷窃癖严重程度评分都有所下降,11 名(91.7%)参与者符合应答标准(主要疗效测量值改善 35%,加上 CGI 改善/非常改善;情绪、焦虑和残疾评分也显著改善,同时停止信号反应抑制也显著改善。美金刚总体上耐受性良好。这项研究表明美金刚在减少购物冲动和偷窃行为以及改善冲动、情绪、焦虑和社会心理功能方面的有效性。

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Memantine reduces stealing behavior and impulsivity in kleptomania: a pilot study.美金刚可减少偷窃癖的偷窃行为和冲动:一项初步研究。
Int Clin Psychopharmacol. 2013 Mar;28(2):106-11. doi: 10.1097/YIC.0b013e32835c8c8c.
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A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania.一项关于阿片类拮抗剂纳曲酮治疗偷窃癖的双盲、安慰剂对照研究。
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A pilot open label prospective study of memantine monotherapy in adults with ADHD.一项关于美金刚单药治疗成人注意缺陷多动障碍的开放标签前瞻性研究。
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Open-label pilot study of memantine in the treatment of compulsive buying.美金刚治疗强迫性购物的开放标签试验性研究。
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Memantine shows promise in reducing gambling severity and cognitive inflexibility in pathological gambling: a pilot study.美金刚在降低病理性赌博的严重程度和认知灵活性方面显示出前景:一项初步研究。
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Memantine in moderate-to-severe Alzheimer's disease.美金刚用于中重度阿尔茨海默病
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Memantine efficacy and safety in patients with acute mania associated with bipolar I disorder: a pilot evaluation.美金刚对伴有双相I型障碍的急性躁狂症患者的疗效及安全性:一项初步评估。
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Open-Label trial on the effects of memantine in adults with obsessive-compulsive disorder after a single ketamine infusion.美金刚对单次氯胺酮输注后成年强迫症患者影响的开放标签试验。
J Clin Psychiatry. 2016 May;77(5):688-9. doi: 10.4088/JCP.15l10318.

引用本文的文献

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Efficacy of Pharmacological Interventions in Targeting Decision-Making Impairments across Substance and Behavioral Addictions.药物干预在针对物质和行为成瘾的决策障碍中的疗效。
Neuropsychol Rev. 2019 Mar;29(1):93-102. doi: 10.1007/s11065-019-09400-z. Epub 2019 Mar 9.
2
Memantine: New prospective in bipolar disorder treatment.美金刚:双相障碍治疗的新展望。
World J Psychiatry. 2014 Dec 22;4(4):80-90. doi: 10.5498/wjp.v4.i4.80.
3
Kleptomania: Beyond serotonin.偷窃癖:超越血清素
J Neurosci Rural Pract. 2014 Nov;5(Suppl 1):S105-6. doi: 10.4103/0976-3147.145244.