Memantine Treatment for Behavioral Improvement in Autism

Background:  Autism often involves repetitive behaviors, receptive language dysfunction, difficulty with transitions, and inefficient problem solving, and lack of social awareness often related to the anterior inferior frontal lobe region. Memantine has been observed in off label use in autistic patients annectdotally to lead to an improvement in functions typically understood to be part of frontal functioning, such problem solving, language processing, and cognitive flexibility and social awareness. Effect is theorized through NMDA receptor antagonist effect in frontal lobes where excess glutaminergic activity may exist in autism.

Objectives:  Investigate the potential impact of memantine on specific neurobehavioral impairments in children diagnosed with an autism spectrum disorder.

Methods:  This retrospective study involved records review of 100 children seen in an outpatient pediatric neurology specialty clinic who were clinically treated off label use with memantine ( dose range 1mgto 10 mg per day). As has been supported in previous literature, there were a large majority of males in this sample of children with autism. Behavioral patterns by parental report and clinician notes were reviewed prior to and following memantine treatment.

Results:  A substantial number of parents reported behavioral improvement following memantine treatment. This included improved receptive language, greater achievement in learning tasks, and improved social awareness and engagement effort. There were infrequent reports of frontal disinhibition with more aggitated behavior in a small minority treated. This was only reason parents asked to stop therapy that was observed. /this medication 

Conclusions:  This retrospective investigation suggests that the behavioral features of autism typically related to anterior brain dysfunction are at least somewhat improved followed memantine treatment.  There were no negative side effects documented. Substantial parental support exists for this treatment; as approximatley 90% of parents opted to continue.