Behavioral and Neural Response to Memantine in Adolescents With Autism Spectrum Disorder
Autism Spectrum Disorder
About this trial
This is an interventional treatment trial for Autism Spectrum Disorder focused on measuring Autism spectrum disorder, Treatment, Adolescents, Memantine, functional Magnetic Resonance Imaging, MRS, Neuroimaging
Eligibility Criteria
INCLUSION CRITERIA
All Participants:
Male and female participants, ages 8-17 years (inclusive)
Participants with Autism Spectrum Disorder:
- Meets Diagnostic and Statistical Manual-5 autism spectrum disorder diagnostic criteria, as established by clinical diagnostic interview
- At least moderate severity of social impairment, as measured by a total raw score of ≥85 on the parent/guardian-completed Social Responsiveness Scale, Second Edition (SRS-2) and a score of ≥4 on the clinician-administered Autism Spectrum Disorder Clinical Global Impression-Severity scale (ASD CGI-S)
Healthy Control Participants:
2. Age-, sex-, and IQ-matched with participants with autism spectrum disorder 3. No Axis I diagnoses, as established by the Kiddie Schedule for Affective Disorders and Schizophrenia-Epidemiological Version (K-SADS-E) and confirmed by clinical diagnostic interview 4. No significant traits of autism spectrum disorder, as measured by a total raw score of <60 on the parent/guardian-completed Social Responsiveness Scale, Second Edition
EXCLUSION CRITERIA
All Participants:
- IQ ≤70 based, on the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) Vocabulary and Matrix Reasoning subtests
- Impaired communicative speech
Current treatment with the following medications, which are known to impact glutamate levels:
- Lamotrigine
- Amantadine
- N-acetylcysteine
- D-cycloserine
- Current treatment with a psychotropic medication, not listed above, on a dose that has not been stable for at least 4 weeks prior to study baseline
- Co-administration of drugs that compete with memantine for renal elimination using the same renal cationic system, including hydrochlorothiazide, triamterene, metformin, cimetidine, ranitidine, quinidine, and nicotine
- Initiation of a new psychosocial intervention within 30 days prior to randomization
- Participants who are pregnant and/or nursing
- Participants with a history of non-febrile seizures without a clear and resolved etiology
- Participants with a history of or a current liver or kidney disease
- Clinically unstable psychiatric conditions or judged to be at serious suicidal risk
- Participants who meet for alcohol or drug dependence or abuse on the Kiddie Schedule for Affective Disorders and Schizophrenia-Epidemiological Version. If the participant has a recent history of substance abuse, as an added precaution, there will be a 2-week washout period before initiating the trial. There are no known safety issues relating to memantine and recent history of substance abuse.
- Serious, stable or unstable, systemic illness, including hepatic, renal, gastroenterological, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, immunologic, or hematologic disease
- Participants with severe hepatic impairment (Liver Function Tests [LFTs] >3 times the Upper Limit of Normal [ULN])
- Participants with genitourinary conditions that raise urine Power of Hydrogen (pH) (e.g., renal tubular acidosis, severe infection of the urinary tract)
- Known hypersensitivity to memantine
- Severe allergies or multiple adverse drug reactions
- A non-responder or history of intolerance to memantine after treatment at adequate doses, as determined by the clinician
- Investigator and his/her immediate family, defined as the Investigator's spouse, parent, child, grandparent, or grandchild.
Sites / Locations
- Massachusetts General Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Placebo Comparator
No Intervention
Memantine
Placebo
Control Group
Participants in the placebo arm will receive placebo (no active ingredients) in capsule form twice daily. It will be administered twice daily for 12 weeks. Participants will undergo neuroimaging before and after the 12-week treatment phase. Placebo: Capsule
Participants in the memantine arm will receive memantine in capsule form twice daily. It will be administered twice daily for 12 weeks (including a 4-week titration phase to a maximum dose of 20 mg per day). Participants will undergo neuroimaging before and after the 12-week treatment phase. Memantine: Capsule
Healthy controls will undergo neuroimaging twice (12 weeks apart) and will receive no intervention during the 12-week window.