TY - JOUR
T1 - Glutamatergic agents in the treatment of compulsivity and impulsivity in child and adolescent psychiatry
T2 - A systematic review of the literature
AU - the TACTICS Consortium
AU - Mechler, Konstantin
AU - Häge, Alexander
AU - Schweinfurth, Nina
AU - Glennon, Jeffrey C.
AU - Dijkhuizen, Rick M.
AU - Murphy, Declan
AU - Durston, Sarah
AU - Williams, Steven
AU - Buitelaar, Jan K.
AU - Banaschewski, Tobias
AU - Dittmann, Ralf W.
AU - De Ruiter, Saskia
AU - Akkermans, Sophie
AU - Mennes, Maarten
AU - Zwiers, Marcel
AU - Ilbegi, Sharhzad
AU - Hennissen, Leonie
AU - Naaijen, Jill
AU - Van De Vondervoort, Ilse
AU - Kapusta, Katarzyna
AU - Bielczyk, Natalia
AU - Amiri, Houshang
AU - Oomen, Charlotte
AU - Havenith, Martha
AU - Franke, Barbara
AU - Poelmans, Geert
AU - Bralten, Janita
AU - Heskes, Tom
AU - Sokolova, Elena
AU - Lythgoe, David
AU - Bruchhage, Muriel
AU - Dud, Iulia
AU - Brandeis, Daniel
AU - Hohmann, Sarah
AU - Boecker, Regina
AU - Wolf, Isabella
AU - Berg, Ruth
AU - Millenet, Sabina
AU - Joel, Daphna
AU - Cryan, John F.
AU - Petryshen, Tracey
AU - Pauls, David
AU - Saito, Mai
AU - Blezer, Erwin
AU - Van Der Marel, Kajo
AU - Pullens, Pim
AU - Mol, Wouter
AU - Van Der Toorn, Annette
AU - Otte, Wim
AU - Van Heijningen, Caroline
N1 - Publisher Copyright:
© 2017 Hogrefe.
PY - 2018/5
Y1 - 2018/5
N2 - Objective: Research has implicated glutamatergic projections between the various frontal subregions in the pathogenesis of compulsivity and impulsivity. Reducing striatal glutamate release, or antagonising the action of glutamate at its receptors, may therefore represent viable treatment strategies. Several glutamatergic agents with regulatory approval for other indications are available and may be of potential benefit in the treatment of compulsivity/impulsivity in psychiatric disorders in paediatric patients. Method: This review was performed according to PRISMA guidelines and evaluates available scientific literature concerning the use of glutamatergic agents in these patients, in order to determine their reported effectiveness/efficacy and tolerability/safety. Results: Out of a total of 1,426 publications, 21 trials examining six glutamatergic substances in patients with obsessive-compulsive disorder, autism spectrum disorders, and attention deficit/hyperactivity disorder were included. Conclusions: Trial designs as well as results were heterogeneous and thus comparability was limited. Available data support the hypothesis that glutamatergic agents are of potential value in the treatment of compulsivity/impulsivity in children and adolescents. Based on the data reviewed, memantine and N-acetylcysteine suggest the best risk-benefit profile for future trials. Riluzole should primarily be further investigated in adults. Clinical research of this nature is a key element of the TACTICS Consortium project funded by the European Union (FP7).
AB - Objective: Research has implicated glutamatergic projections between the various frontal subregions in the pathogenesis of compulsivity and impulsivity. Reducing striatal glutamate release, or antagonising the action of glutamate at its receptors, may therefore represent viable treatment strategies. Several glutamatergic agents with regulatory approval for other indications are available and may be of potential benefit in the treatment of compulsivity/impulsivity in psychiatric disorders in paediatric patients. Method: This review was performed according to PRISMA guidelines and evaluates available scientific literature concerning the use of glutamatergic agents in these patients, in order to determine their reported effectiveness/efficacy and tolerability/safety. Results: Out of a total of 1,426 publications, 21 trials examining six glutamatergic substances in patients with obsessive-compulsive disorder, autism spectrum disorders, and attention deficit/hyperactivity disorder were included. Conclusions: Trial designs as well as results were heterogeneous and thus comparability was limited. Available data support the hypothesis that glutamatergic agents are of potential value in the treatment of compulsivity/impulsivity in children and adolescents. Based on the data reviewed, memantine and N-acetylcysteine suggest the best risk-benefit profile for future trials. Riluzole should primarily be further investigated in adults. Clinical research of this nature is a key element of the TACTICS Consortium project funded by the European Union (FP7).
KW - Clinical trials
KW - Compulsivity
KW - Glutamate
KW - Impulsivity
KW - Systematic review
UR - https://www.scopus.com/pages/publications/85046468531
U2 - 10.1024/1422-4917/a000546
DO - 10.1024/1422-4917/a000546
M3 - Review article
C2 - 28922069
AN - SCOPUS:85046468531
SN - 1422-4917
VL - 46
SP - 246
EP - 263
JO - Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie
JF - Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie
IS - 3
ER -