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Related Experiment Videos

Memantine for dementia.

A Areosa Sastre, R McShane, F Sherriff

    The Cochrane Database of Systematic Reviews
    |October 21, 2004
    PubMed
    Summary

    Memantine (a low affinity antagonist to N-Methyl-D-aspartate receptors) shows benefits in moderate to severe Alzheimer's disease, improving cognition and daily living. Its effects in vascular dementia are less clear, though some cognitive improvements were noted.

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    Area of Science:

    • Neuroscience
    • Pharmacology
    • Geriatrics

    Background:

    • Alzheimer's disease, vascular dementia, and mixed dementia are prevalent in older adults.
    • L-glutamate excitotoxicity is implicated in Alzheimer's pathogenesis and ischemic stroke damage.
    • Memantine, an N-Methyl-D-aspartate (NMDA) receptor antagonist, may mitigate neurotoxicity while preserving glutamate's physiological functions.

    Purpose of the Study:

    • To evaluate the clinical efficacy and safety of memantine in patients with Alzheimer's disease, vascular dementia, or mixed dementia.

    Main Methods:

    • Systematic review of double-blind, placebo-controlled, randomized trials of memantine in dementia patients.
    • Searches conducted on the Cochrane Dementia and Cognitive Improvement Group's Specialized Register and major health databases.
    • Data extraction and analysis using intention-to-treat (ITT) and observed cases (OC) approaches, with pooled effect estimations.

    Main Results:

    • Memantine demonstrated positive effects on cognition, mood, behavior, and daily living activities in moderate to severe Alzheimer's disease.
    • In mild to moderate vascular dementia, 20mg/day memantine showed cognitive benefits at 28 weeks, but not in daily living or clinical impression.
    • Early beneficial effects on cognition, mood, behavior, and clinical impression were observed at 6 weeks.

    Conclusions:

    • Memantine (20 mg/day) significantly reduced deterioration in moderate to severe Alzheimer's disease over 28 weeks, with improvements in function and cognition.
    • Patients on memantine showed reduced agitation; effects in mild to moderate Alzheimer's disease remain unknown.
    • While memantine improved cognition in mild to moderate vascular dementia, these effects were not clinically discernible; the drug is generally well-tolerated with a low incidence of adverse effects.

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