Joshi et al., 2013

Glutamate Act iv i ty in ACC

dACC0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1

**1.5

TDASD

Mea

n G

luta

mat

e le

vels

(IU)

Statistical Significance: **p≤0.01

Spectroscopy in Adolescent Males with HF-Autistic Disorder

Higher glutamate in this area of the brain is hypothesized to be associated with ASD.

Clinical Trials Registration @ ClinicalTrials.govRegistration Number: NCT01333865URL: http://www.clinicaltrials.gov/ct2/show/NCT01333865

Study Approved by: Partners Human Research Committee Institutional Review Board

Study Funded by: the Norma Fine Pediatric Psychopharmacology Fellowship Fund & the Pediatric Psychopharmacology Council Fund

12-week Open-label Trial of Anti-Glutamate Agent

Memantine Hydrochloride (Namenda)

for the Treatment ofSocial Impairment in Young Adults with

High-functioning Autism Spectrum Disorder

Clinical and Research Program in Pediatric Psychopharmacology

ASD Features: Mean ResponseInformant-Rated: Social Responsiveness Scale (SRS)

Clinical and Research Program in Pediatric Psychopharmacology

0 6 1260

70

80

90

100

Weeks

SRS

Mea

n Sc

ore

SRS: Mean Raw ScoreBaseline: 99 ±17Endpoint: 71 ±18

Reduction: 28 ±25Effect Size: 1.57

Statistical Significance: *p≤0.05, **p≤0.01, ***p≤0.001

***

Take away: Caretakers rated patients to have improvements in social skills and behavior after trial of Namenda.

0 6 1210

15

20

25

30

35

40

Weeks

ASD

Ratin

g Sc

ale

Socia

l inte

racti

on

Socia

l Com

mun

icatio

n

Mot

or M

anne

rism

s0

2

4

6

8

10

12

14

16

***

*** ***

Baseline Endpoint

Me

an

Sco

re

Total Mean Response

***

Mean Response by Domain

ASD-RS Mean TotalBaseline: 31 ±7.4Endpoint: 21 ±8.3

Reduction: 10 ±7Effect Size: 1.30

Clinical and Research Program in Pediatric Psychopharmacology

Clinician-Rated: ASD Rating Scale

ASD Features: Mean Response

Statistical Significance: *p≤0.05, **p≤0.01, ***p≤0.001

Non-verbal Communication Performance

Clinical and Research Program in Pediatric Psychopharmacology

Reading Non-Verbal Emotional Cues: DANVA2 Performance

Total Errors

Statistical Significance: *p≤0.05, **p≤0.01, ***p≤0.001

Paralanguage Faces0

1

2

3

4

5

6

7

8

9

10

**

Baseline Endpoint

To

tal E

rro

rs M

ea

n S

core

Take Away: After medication, patients show increase in abiity to recognize emotions conveyed through facial expressions

Adverse Events

Clinical and Research Program in Pediatric Psychopharmacology

Reported > I visit

Experienced any AEs: 6 (33.3%)

Serious AEs: None

Treatment Limiting AEs: N=1Decreased energy,emotional numbness,feeling dissociated,feeling on edge(resolved on d/c)

Musculoskeletal

Decreased energy

Insomnia

Cold/Infection/Allergy

Headache

0% 2% 4% 6% 8% 10% 12%

Subjects (%)

Take away: Patients reported very few adverse side effects while on Namenda

Reimer, Fried, Biederman et al., 2013

Impaired driving ability associated with autism

The MIT AgeLab Driving Simulator

Character iz ing Dr iv ing Behavior

in Young Adults wi th ASD

Difficulties attending to the roadway:

- Higher vertical gaze position

- Wider dispersion of horizontal gaze scanning

- Focus more on the median

Drive at higher level of arousal:

- Increased level of anxiety