Memantine: a review of possible uses in child and adolescent psychiatry

Abstract

Objective: To provide a review of published literature regarding the pharmacology of memantine and potential benefits for use in child and adolescent psychiatry.

Method: A LITERATURE SEARCH OF SEVERAL DATABASES (MEDLINE, PSYCHINFO, CINAHL, PSYCARTICLES) WAS CONDUCTED WITH THE SEARCH TERMS: 'memantine' with limits: English language, Human trials, all child (aged 0-18 years). The search was later expanded to include 'Adults' and relevant articles were also selected from reference lists.

Result: The search did not find any well-controlled studies in children and adolescents except for open label trials, as monotherapy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), as well as an augmenting agent in obsessive compulsive disorder (OCD). No study was found in anxiety disorders (AD), the most common psychiatric disorder in children or in mood disorders, both major depressive disorder (MDD) and bipolar disorder (BD). Studies in adults for those disorders with onset in childhood or adolescence, were also mostly open-label and as an add-on therapy. All the studies reported that memantine is a safe drug with minimal drug interactions and a very acceptable adverse effect profile comparable to placebo.

Conclusion: Memantine has demonstrated beneficial effects in some childhood disorders but the evidence is too limited at present and does not provide enough support of its efficacy to advocate for its regular use in those conditions. Such use remains off-label until further validation of efficacy comes from blinded, randomized, placebo controlled studies.

Keywords: NMDA receptor antagonist; adolescents; children; glutamatergic system; memantine; pharmacology.