Memantine for autistic children: what the evidence shows so far

In one sentence

Current research does not show clear evidence that memantine improves core autism-related difficulties in autistic children and teenagers.

What the researchers did

Researchers reviewed three clinical trials involving just over 200 autistic children and adolescents.

Memantine is a medication more commonly used for dementia and memory-related conditions. Some doctors and researchers have also explored whether it could help with autism-related difficulties such as irritability, attention, communication, or behavior.

In the studies, memantine was compared with placebo or added to other forms of support. Researchers looked at areas including:

• core autism characteristics;
• language and communication;
• memory;
• adaptive skills;
• hyperactivity;
• and irritability.

What they found

The review did not find convincing evidence that memantine clearly improves the main features associated with autism.

For language, memory, irritability, hyperactivity, and everyday functioning, the results were also unclear. Some studies reported small positive changes, but the evidence was too limited and inconsistent to draw strong conclusions.

The researchers also stressed that the studies themselves were small and had important quality problems. Because of this, the current evidence is considered weak and uncertain.

There was also no strong sign that memantine caused more serious side effects than placebo, but the available safety information was limited.

Importantly, all studies involved children and teenagers only. There is almost no research on memantine in autistic adults.

What this means for families and therapists

This review does not support memantine as a proven or standard autism treatment based on current evidence.

Some clinicians may still discuss memantine for specific co-occurring difficulties such as severe irritability or attention problems. But families should understand that the scientific evidence remains limited.

If medication is being considered, it may help to discuss:

• what specific problem the medication is targeting;
• what changes are realistically expected;
• how progress will be monitored;
• and what possible side effects to watch for.

The review also leaves open the possibility that future, better-quality studies could change what researchers currently believe. But at the moment, there is not enough evidence to support routine use.

Limitations and what we don't know yet

Only three small studies were available, which makes the findings uncertain.

The studies were also short-term, so researchers still know very little about long-term effects or long-term safety.

Because the evidence quality was rated low, future research could potentially lead to different conclusions.

The review also does not answer whether memantine could help very specific subgroups of autistic people with particular co-occurring conditions.

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This is a simplified summary of Memantine for autism spectrum disorder by Brignell A, Marraffa C, Williams K et al., Cochrane Database of Systematic Reviews (2022).

Source license: CC-BY-NC-4.0.

This is not medical advice. Please consult a qualified healthcare professional before making treatment decisions.