Memantine (Namenda) Protocol
Frontier Health and Wellness (FHW) now offers a structured memantine (Namenda) treatment option for some people with Autism Spectrum Disorder (ASD). Memantine is FDA-approved for Alzheimer’s disease. In autism, it is sometimes used even though it is not FDA-approved for ASD. We use it as a careful, step-by-step trial with regular check-ins and progress tracking.
Important: Right now, Dr. E. David Hjellen is the only provider at FHW who prescribes memantine for this autism protocol. If you want to explore this option, you must request an appointment with Dr. Hjellen.
​
​
​
​
​
​
​​​
Quick Links and Information
​
Memantine (Namenda) Quick Fit Check
​
Memantine (Namenda) Package Insert
​
Memantine (Namenda) Off Label Use Warning
Memantine for Autism Spectrum Disorder: Understanding the Rationale and Science
​
What this treatment is (and what to expect)
Memantine is a medicine that affects a brain signal system called glutamate. In some people with autism, this system may be “too turned on,” which can make social connection harder. The main goal of this trial is to improve social responsiveness, such as social engagement, social back-and-forth, and less social withdrawal. It is not expected to fix everything related to autism, and it is not a cure.
Research suggests memantine may help a subset of patients more than others. In one research subgroup that matched the brain pattern most linked to response, about 80% improved with memantine compared to about 20% on placebo. That is why we treat this as a structured trial with clear goals and careful tracking, rather than an open-ended medication.
​
What this treatment is not
Memantine is not expected to strongly improve other areas like ADHD symptoms, anxiety, depression, or overall functioning in the short term. It also does not replace school supports, therapy, skills programs, or family supports. Those remain important parts of care.
​
How This Protocol Was Built
This memantine protocol was not copied from a template or taken from a single study. Dr. Hjellen developed it through an extensive, multi-stage review of the peer-reviewed literature across neuroimaging, neurochemistry, and clinical treatment trials in autism, then integrated those findings into a structured, measurement-based approach designed for real-world community care. Because the research base is mixed and subgroup-dependent, the protocol required careful synthesis of conflicting results, translation of research-only methods into clinically usable screening and tracking tools, and ongoing refinement as new evidence emerges.
​
Who may be a reasonable fit
This option may be a better fit for someone who:
-
Has an ASD diagnosis confirmed through FHW’s full diagnostic process
-
Has a caregiver who can attend visits and share updates
-
Shows a clinical pattern that may match the group most likely to respond
Some research uses special brain scans that are not available for routine care. Because of that, FHW may use a screening checklist (GPS-A) to help decide if a memantine trial is worth doing.
This checklist is helpful, but it is not perfect.
​
Required first step: a full diagnostic assessment
Before starting this protocol, FHW requires a complete diagnostic assessment to:
-
Confirm ASD
-
Look for other conditions that may also need treatment
-
Set a clear baseline (where things are starting) so we can measure change over time
This matters because if the starting picture is unclear, it becomes hard to tell what is helping and what is not.
​
What participation looks like at FHW
This program has three parts: Screening → Dose increases → Ongoing follow-up.
Screening (baseline): We collect starting information, including parent questionnaires, clinician ratings, and height/weight. We also review risks and benefits and complete informed consent.
Dose increases (first few weeks): The dose is usually increased cautiously over the first 6 appointments. Each increase requires an appointment to check tolerability and early signals.
Ongoing follow-up (if benefit is seen): After a working dose is reached, the remainder of your appointments are scheduled through the first year. Families should expect about 16 appointments over 12 months if accepted into the protocol. We also do a structured benefit review around 12 weeks, and we continue only if the benefit is clear and side effects are
acceptable.
​
How we measure progress
At each appointment we will assess numerous symptomatic domains, mood, socialization, sleep, side effects etc.). Additionally, we will use simple tools to track change over time, including:
-
Questionnaires about social responsiveness (SRS-2)
-
Clinician ratings of change over time (CGI-I)
-
Profile checklists used for tracking (GPS-A)
If memantine helps, the change should show up mainly as improved social engagement and less social withdrawal, not necessarily broad improvement in every symptom area.
​
Side effects and why close monitoring is required
Most research suggests memantine is tolerated well, but some people may experience side effects during dose increases. Families should watch for:
More common (usually mild):
-
Headache
-
Sleep changes (more tired or more awake)
-
Appetite changes
-
Stomach upset
-
Vivid dreams
-
Mild irritability
Less common but important:
-
Increased agitation or big increases in irritability
-
Increased anxiety during dose increases
-
Dizziness that limits dosing
If memantine is stopped, we typically taper slowly to reduce rebound symptoms.
​
Cost and insurance
Because memantine is not FDA-approved for autism, insurance coverage is not expected.
Families should plan for out-of-pocket cost and confirm current pricing independently.
​
How to request an evaluation with Dr. Hjellen
1. Submit a request for psychiatric services/medication management through the FHW intake process.
2. Write: “Autism Protocols – Memantine evaluation with Dr. Hjellen.”
3. Complete the required diagnostic assessment. If appropriate, screening tools will be completed and next steps will be discussed.
​
Disclaimer
This webpage is for general education and is not medical advice for any individual. If there is an emergency, call 911 or go to the nearest emergency department.