MEMANTINE USER GUIDE FOR CHILDREN WITH AUTISM SPECTRUM
Memantine - an NMDA receptor antagonist, helps improve specific brain functions and is US FDA approved for use in ADULTS with Alzheimer's Disorder. Its use in any other indication is currently "Off Label" and is at the discretion of the treating physician.
Studies are underway to establish its roles in other disorders, including in Autism Spectrum Disorder in children and adolescents.
As per "Memantine for the Treatment of Autism Spectrum Disorder: Overview of the Phase II Clinical Development Program (S42.009), Ephraim Katz, Jordan Lateiner, Allan Spera, Robert Palmer and Stephen Graham; Neurology April 8, 2014 vol. 82 no. 10 Supplement S42.009, as publised in http://www.neurology.org/content/82/10_Supplement/S42.009 (last accessed 6th June 2016)":
Memantine, an antagonist of N-methyl-D-aspartate glutamate receptors, is approved for patients with moderate to severe Alzheimer’s disease (AD), in whom it was shown to provide communication benefits. Memantine-associated benefits in communication and social behavior also have been observed in open-label autism trials.
Considering the investigational nature of the drug, only links and abstracts in public domain are being provided below without comments, so that the parent of an Autism affected child may be in a position to understand what is being attempted to help the child, and to make an informed choice about the use of this drug in his/her child, whose regulatory clinical trials in children are underway as at present.
Memantine as Adjunctive Therapy in Children Diagnosed With Autistic Spectrum Disorders: An Observation of Initial Clinical Response and Maintenance Tolerability
Michael G. Chez, MD et al, adapted from http://jcn.sagepub.com/content/22/5/574.short (last accessed on 6th June 2016)
Autism and Pervasive Developmental Disorder Not Otherwise Specified are common developmental problems often seen by child neurologists. There are currently no cures for these lifelong and socially impairing conditions that affect core domains of human behavior such as language, social interaction, and social awareness. The etiology may be multifactorial and may include autoimmune, genetic, neuroanatomic, and possibly excessive glutaminergic mechanisms. Because memantine is a moderate affinity antagonist of the N-methylD-aspartic acid (NMDA) glutamate receptor, this drug was hypothesized to potentially modulate learning, block excessive glutamate effects that can include neuroinflammatory activity, and influence neuroglial activity in autism and Pervasive Developmental Disorder Not Otherwise Specified. Open-label add-on therapy was offered to 151 patients with prior diagnoses of autism or Pervasive Developmental Disorder Not Otherwise Specified over a 21-month period. To generate a clinician-derived Clinical Global Impression Improvement score for language, behavior, and self-stimulatory behaviors, the primary author observed the subjects and questioned their caretakers within 4 to 8 weeks of the initiation of therapy. Chronic maintenance therapy with the drug was continued if there were no negative side effects. Results showed significant improvements in open-label use for language function, social behavior, and self-stimulatory behaviors, although self-stimulatory behaviors comparatively improved to a lesser degree. Chronic use so far appears to have no serious side effects.
Memantine as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial, Ali Ghaleiha et al, International Journal of Neuropsychopharmacology (2013), 16, 783–789, See full article on http://ijnp.oxfordjournals.org/content/ijnp/16/4/783.full.pdf, last accessed on 6th June 2015
A retrospective study of memantadine in children and adolescents with pervasive developmental disorders; Erikson CA et al, Psychopharmacology, 2007, 191: 141-147: See http://link.springer.com/article/10.1007/s00213-006-0518-9#page-2 ; last accessed 6 June 2016
A Prospective, Open-Label Trial of Memantine in the Treatment of Cognitive, Behavioral, and Memory Dysfunction in Pervasive Developmental Disorders, Owley T et al, Journal of Child and Adolescent Psychopharmacology, 16 (5): 2006
Background: This pilot study examined the effectiveness of memantine hydrochloride in improving cognitive functioning and behavioral symptoms in children with pervasive developmental disorders (PDDs).
Method: Subjects aged 3–12 years inclusive were enrolled in this 8-week, open-label study. Expressive and receptive language, nonverbal IQ, and nonverbal memory measures were administered at baseline and after 8 weeks of treatment with 0.4 mg/kg of memantine hydrochloride. Throughout the study, the Aberrant Behavior Checklist (ABC) was sent in weekly by parents as a measure of behavioral change.
Results: Twelve of 14 subjects completed the study. Significant improvement from baseline was noted on the memory test (Children’s Memory Scale Dot Learning Subtest). There were no significant differences from baseline on measures of expressive or receptive language or nonverbal IQ. There were significant improvements on a number of ABC subscales, including hyperactivity, lethargy, and irritability. There were no overall significant statistical differences from baseline on the Clinical Global Improvement—Severity (CGI-S) scale. On the Clinical Global Improvement-Improvement (CGI-I), 4 of 14 subjects showed minimal improvement, and none was deemed “much-improved” or “very much improved.”
Conclusions: This small, prospective, open-label study suggests that memantine may be useful in the treatment of memory functioning and some behavioral symptoms in PDDs. The investigators did not see the same degree of change as endorsed by caretakers. Controlled studies are needed to substantiate and clarify these preliminary findings.
There are many more papers like these. See googlesholar.com for further information using the key words "memantine autism".