autism, a study with negative results. This was a monotherapy study, unlike the above studies in which memantine was added to treatment with another drug. Findling found that extended release memantine (at doses of 3mg to 15mg per day) was well tolerated in children with autism, but the drug on its own was not significantly more effective than placebo in these preliminary studies.
Editor’s Note: Taken together, these data suggest an emerging role for memantine and possibly other drugs that work through NMDA receptor blockade in several disorders associated with repetitive behavior, like OCD and autism. The role of memantine augmentation in each of these syndromes deserves further exploration.
At the 2012 meeting of the American Academy of Child and Adolescent Psychiatry (AACAP), Melissa P. DelBello presented a poster on the design of a maintenance study in bipolar youth to determine characteristics of patients who stabilized on adjunctive lamotrigine. The study included children aged 10 to 17 who had been diagnosed with bipolar disorder. Of a total 244 potential subjects, 160 individuals or 66% stabilized on lamotrigine during the open (not blind) portion of the study. Of these, 143 were randomized to either lamotrigine continuation or placebo.
Seventeen participants did not enter the randomized phase of the study, primarily because of withdrawal of consent, presumably because they were reluctant to be placed in the placebo group. The authors concluded that a study design involving randomization to medication continuation versus withdrawal with placebo substitution could underestimate the true level of treatment response.
However, the high stabilization rate of 66% using adjunctive lamotrigine in the open phase of the study suggests that the drug is effective. Clearly confirmation of this in the double-blind randomized phase is needed to confirm this prediction.
Adults with bipolar disorder have higher rates of cardiovascular disease and premature death from cardiovascular illness than the general population. At the 2012 meeting of the American Academy of Child and Adolescent Psychiatry, Benjamin Goldstein presented a poster in which he showed that youth with bipolar disorder may also have abnormal cardiovascular function.
When a tourniquet is applied, blood vessels normally expand to make up for the period of oxygen deprivation. This does not happen as readily in patients with mood disorders. This lack of flexibility and compensatory response could be one of the reasons for increased cardiovascular difficulties in those with mood disorders.
In Goldstein’s study, noninvasive ultrasound imaging was used to measure the thickness of the walls of the carotid artery and flow mediated dilation of the artery in adolescents with bipolar disorder and those without the illness. The data was collected by a certified ultrasound technologist who remained blind to the patients’ diagnostic and symptom status.
Goldstein found highly abnormal results in 14 adolescents aged 14 to 19 with bipolar disorder compared to controls. He concluded that reducing cardiovascular risk in bipolar disorder is a pressing clinical and public health challenge and that treating these patients while they are adolescents may offer considerable advantages both for prevention and for understanding the progression of cardiovascular problems in patients with bipolar disorder.
A study of 85,000 children in Norway that was recently published in the Journal of the American Medical Association showed that women who took folic acid during pregnancy were 40% less likely to have a child who developed autism.
A summary of the research by National Public Radio explained:
Folic acid is the synthetic version of a B vitamin called folate. It’s found naturally in foods such as spinach, black-eyed peas and rice. Public health officials recommend that women who may become pregnant take at least 400 micrograms of folic acid every day to reduce the chance of having a child with spina bifida.
The folic acid’s effect reduced the most severe cases of autism but did not seem to have 