Choi Won-Seok, Wang Sheng-Min, Woo Young Sup, Bahk Won-Myong
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Woo and Bahk Psychiatry Clinic, Seoul, Republic of Korea.
J Clin Psychiatry. 2024 Dec 25;86(1):24r15507. doi: 10.4088/JCP.24r15507.
Pharmacotherapy plays a crucial role in treating attention-deficit/ hyperactivity disorder (ADHD). However, current medications for ADHD have limitations and potential adverse effects. Glutamate, a neurotransmitter that directly and indirectly modulates dopamine neurotransmission, is considered a new therapeutic target for ADHD. We conducted a systematic review to determine the efficacy and safety of memantine, an uncompetitive -methyl D-aspartate (NMDA) receptor antagonist, in both pediatric and adult patients with ADHD. We searched PubMed, EMBASE, PsycINFO, and Cochrane Library for articles on memantine use in ADHD patients published up to August 31, 2023, using terms related to ADHD and memantine. Studies selected according to PRISMA guidelines. We included both randomized and nonrandomized trials for a comprehensive review. We excluded non-English publications, review articles, and studies without full text. Two authors extracted data using the data extraction form designed for this review. Independent authors conducted a risk of bias assessment using risk of bias 2 (RoB 2) and Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I). Six studies met the inclusion criteria, 3 on pediatric populations, and 3 on adults. Three studies were conducted in the United States (2 in adults) and 3 in Iran (1 in adults). Memantine showed potential benefits in managing ADHD symptoms and had a favorable safety profile. However, most studies involved small patient groups at single institutions, and their quality was low. Memantine has the potential to be a relatively safe alternative or adjunctive treatment for ADHD, but more refined studies with larger populations are needed. .
药物治疗在注意力缺陷多动障碍（ADHD）的治疗中起着至关重要的作用。然而，目前用于治疗ADHD的药物存在局限性和潜在的不良反应。谷氨酸是一种直接和间接调节多巴胺神经传递的神经递质，被认为是ADHD的一个新的治疗靶点。我们进行了一项系统评价，以确定美金刚（一种非竞争性N-甲基-D-天冬氨酸（NMDA）受体拮抗剂）在儿童和成人ADHD患者中的疗效和安全性。我们在PubMed、EMBASE、PsycINFO和Cochrane图书馆中搜索截至2023年8月31日发表的关于美金刚用于ADHD患者的文章，使用与ADHD和美金刚相关的术语。根据PRISMA指南选择研究。我们纳入了随机和非随机试验进行全面综述。我们排除了非英文出版物、综述文章和没有全文的研究。两位作者使用为本综述设计的数据提取表提取数据。独立作者使用偏倚风险2（RoB 2）和干预非随机研究中的偏倚风险（ROBINS-I）进行偏倚风险评估。六项研究符合纳入标准，三项针对儿童人群，三项针对成人。三项研究在美国进行（两项针对成人），三项在伊朗进行（一项针对成人）。美金刚在控制ADHD症状方面显示出潜在益处，并且安全性良好。然而，大多数研究涉及单个机构的小患者群体，且质量较低。美金刚有可能成为ADHD相对安全的替代或辅助治疗方法，但需要更多针对更大人群的精细研究。
