A Prospective Open-Label Trial of Memantine Hydrochloride for the Treatment of Social Deficits in Intellectually Capable Adults With Autism Spectrum Disorder.
A Prospective Open-Label Trial of Memantine Hydrochloride for the Treatment of Social Deficits in Intellectually Capable Adults With Autism Spectrum Disorder.
复制标题
盐酸美金刚用于治疗患有自闭症谱系障碍的智力正常成人的社交缺陷的前瞻性开放标签试验。
DOI：
10.1097/jcp.0000000000000499
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发表时间：
2016
影响因子：
2.9
通讯作者：
Biederman,Joseph
中科院分区：
文献类型：
--
作者：
Joshi,Gagan;Wozniak,Janet;Faraone,StephenV;Fried,Ronna;Chan,James;Furtak,Stephannie;Grimsley,Emily;Conroy,Kristina;Kilcullen,JRyan;Woodworth,KYvonne;Biederman,Joseph
这项为期12周的前瞻性开放标签试验评估了盐酸美金刚治疗高功能自闭症谱系障碍（ASD）成人核心社会和认知缺陷的耐受性和疗效。评估治疗反应的措施包括社会反应量表-成人研究版（SRS-A），障碍特异性临床整体印象量表，执行功能行为评定量表-成人自我报告，非语言准确性诊断分析量表和剑桥神经心理测试自动化组。18名患有高功能ASD的成人（平均年龄28±9.5岁）（SRS-A原始评分99±17）接受美金刚治疗（平均剂量19.7±1.2 mg/d，范围15-20 mg）， 17名（94%）完成了试验。使用美金刚治疗显著降低了被调查者评定（SRS-A, - 28±25；P< 0.001）和临床医生评定（临床总体印象改善量表≤2,83%）的自闭症严重程度。此外，美金刚治疗与ADHD和焦虑症状严重程度的显著改善相关。在非语言交流诊断分析的非语言准确性量表测试和执行功能的自我报告（执行功能行为评定量表-成人自我报告全球执行复合，−6±8.8；P< 0.015）和神经心理评估（剑桥神经心理测试自动化电池）显著改善。美金刚治疗通常耐受性良好，没有任何严重的不良事件。用美金刚治疗似乎有利于治疗ASD和相关的精神病理和认知功能障碍的智力有能力的成年人。未来的安慰剂对照试验是有必要的。
This prospective 12-week open-label trial evaluates the tolerability and efficacy of memantine hydrochloride for the treatment of core social and cognitive deficits in adults with high-functioning autism spectrum disorder (ASD). Measures for assessment of therapeutic response included the Social Responsiveness Scale-Adult Research Version (SRS-A), disorder-specific Clinical Global Impression scales, Behavior Rating Inventory of Executive Functioning–Adult Self-Report, Diagnostic Analysis of Nonverbal Accuracy Scale, and Cambridge Neuropsychological Test Automated Battery. Eighteen adults (mean age, 28±9.5 years) with high-functioning ASD (SRS-A raw score, 99±17) were treated with memantine (mean dose, 19.7±1.2 mg/d; range, 15–20 mg), and 17 (94%) completed the trial. Treatment with memantine was associated with significant reduction on informant-rated (SRS-A,− 28±25; P< 0.001) and clinician-rated (Clinical Global Impression-Improvement subscale≤ 2, 83%) measures of autism severity. In addition, memantine treatment was associated with significant improvement in ADHD and anxiety symptom severity. Significant improvement was noted in nonverbal communication on the Diagnostic Analysis of Nonverbal Accuracy Scale test and in executive function per self-report (Behavior Rating Inventory of Executive Functioning–Adult Self-Report Global Executive Composite,− 6±8.8; P< 0.015) and neuropsychological assessments (Cambridge Neuropsychological Test Automated Battery). Memantine treatment was generally well tolerated and was not associated with any serious adverse events. Treatment with memantine appears to be beneficial for the treatment of ASD and associated psychopathology and cognitive dysfunction in intellectually capable adults. Future placebo-controlled trials are warranted.