Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois 60637, USA.
Int Clin Psychopharmacol. 2013 Mar;28(2):106-11. doi: 10.1097/YIC.0b013e32835c8c8c.
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.
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。