Open-label pilot study of memantine in the treatment of compulsive buying.
ABSTRACT Although compulsive buying (CB) is relatively common, pharmacotherapy research for CB is limited. Memantine, an N-methyl-D-aspartate receptor antagonist, appears to reduce glutamate excitability and improve impulsive behaviors, suggesting it may help individuals with CB.
Nine patients (8 females) with CB were enrolled in a 10-week open-label treatment study of memantine (dose ranging from 10 to 30 mg/d). Participants were enrolled from December 2008 until May 2010. The primary outcome measure was change from baseline to study endpoint on the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV).
Of the 9 participants, 8 (88.9%) completed the 10-week study. Y-BOCS-SV scores decreased from a mean of 22.0 ± 1.3 at baseline to 11.0 ± 5.3 at endpoint (P < .001). Hours spent shopping per week and money spent shopping both decreased significantly (P < .001). The mean effective dose of memantine was 23.4 ± 8.1 mg/d. Memantine treatment was associated with diminished impulsive buying and improvements on cognitive tasks of impulsivity. In addition, the medication was well-tolerated.
These findings suggest that pharmacologic manipulation of the glutamate system may target the impulsive behavior underlying CB. Placebo-controlled, double-blind studies are warranted in order to confirm these preliminary findings in a controlled design.
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ABSTRACT: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects 1 in 68 children in the United States. Even though it is a common disorder, only two medications (risperidone and aripiprazole) are approved by the U.S. Food and Drug Administration (FDA) to treat symptoms associated with ASD. However, these medications are approved to treat irritability, which is not a core symptom of ASD. A number of novel medications, which have not been approved by the FDA to treat ASD have been used off-label in some studies to treat ASD symptoms, including medications approved for Alzheimer's disease. Interestingly, some of these studies are high-quality, double-blind, placebo-controlled (DBPC) studies. This article systematically reviews studies published through April, 2014, which examined the use of Alzheimer's medications in ASD, including donepezil (seven studies, two were DBPC, five out of seven reported improvements), galantamine (four studies, two were DBPC, all reported improvements), rivastigmine (one study reporting improvements), tacrine (one study reporting improvements), and memantine (nine studies, one was DBPC, eight reported improvements). An evidence-based scale was used to rank each medication. Collectively, these studies reported improvements in expressive language and communication, receptive language, social interaction, irritability, hyperactivity, attention, eye contact, emotional lability, repetitive or self-stimulatory behaviors, motor planning, disruptive behaviors, obsessive-compulsive symptoms, lethargy, overall ASD behaviors, and increased REM sleep. Reported side effects are reviewed and include irritability, gastrointestinal problems, verbal or behavioral regression, headaches, irritability, rash, tremor, sedation, vomiting, and speech problems. Both galantamine and memantine had sufficient evidence ranking for improving both core and associated symptoms of ASD. Given the lack of medications approved to treat ASD, further studies on novel medications, including Alzheimer's disease medications, are needed.Frontiers in Pediatrics 01/2014; 2:87.
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ABSTRACT: Although addictive syndromes have been traditionally related to substance-use disorders, during the last few decades a novel addictive group, including the so-called "behavioral or no-drug addictions," has been recognized and has attracted increasing attention for its relevant social impact. This group includes pathological gambling, compulsive shopping, TV/Internet/social network/videogame addictions, workaholism, sex and relationship addictions, orthorexia, and overtraining syndrome. Substance and behavioral addictions show similar phenomenological features, such as craving, dependence, tolerance, and abstinence, and perhaps they share a common possible pathophysiology. It is, however, controversial whether all or at least some of them should be considered real disorders or just normal, albeit extreme, behaviors. The aim of this article is to review current data on pharmacological treatment of behavioral addictions. As no specific and validated treatment algorithms are currently available, only an improved knowledge on their psychopathological, clinical, and neurobiological features may have relevant implications for more focused preventive and therapeutic strategies.CNS spectrums 03/2014; · 1.73 Impact Factor
Article: Compulsive buying.[Show abstract] [Hide abstract]
ABSTRACT: Although compulsive buying (CB) seems to be not only prevalent but even increasing in prevalence, it often remains neglected or minimized in clinical settings. There is a need for a greater understanding and recognition of this problem. The aim of this article is to summarize the current knowledge regarding CB and to offer thoughts regarding classification. Review of published literature over the period 1994-2013 through Pubmed/Medline, PsychINFO, and Google Scholar using the key words 'compulsive buying', 'impulsive buying' and 'addictive buying'. CB is defined by a preoccupation with buying and shopping, by frequent buying episodes, or overpowering urges to buy that are experienced as irresistible and senseless. The maladaptive spending behavior is associated with serious psychological, social, occupational, and financial problems. Treatment-seeking patients with CB suffer from substantial psychiatric comorbidity (eg, anxiety and depressive mood disorders, compulsive hoarding, binge eating disorder). Representative surveys revealed prevalence estimates of CB between 6% and 7% and indicate that younger people are more prone to develop CB. Moreover, European data suggest an increase of CB in the adult population over the last 20 years. While there is no evidence for the efficacy of psychopharmacological treatment, group cognitive behavioral therapy has been shown to be effective. The relevance of recognition of CB as mental disorder is undeniable in the face of its estimated prevalence and associated burden. As our understanding of contributing neurobiological and etiological factors is limited, further research should focus on these topics, taking into account the heterogeneity of individuals with CB. There is also a need for specific treatment options and for the development of prevention strategies. (Am J Addict 2013;XX:1-6).American Journal on Addictions 10/2013; · 1.74 Impact Factor