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Related Experiment Videos

Memantine for dementia.

Sastre A Areosa, F Sherriff, R McShane

    The Cochrane Database of Systematic Reviews
    |July 22, 2005
    PubMed
    Summary

    Memantine shows a small benefit for moderate to severe Alzheimer's disease (AD) in cognition, daily living, and behavior. Its effects on mild to moderate AD and vascular dementia require further investigation.

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    Area of Science:

    • Neuroscience
    • Pharmacology
    • Geriatrics

    Background:

    • Memantine, a glutamate NMDA receptor antagonist, is explored for its potential to mitigate excitotoxic neurotoxicity in dementia.
    • Excitotoxicity is a key pathological process implicated in various neurodegenerative conditions.

    Purpose of the Study:

    • To evaluate the efficacy and safety of memantine in patients diagnosed with Alzheimer's disease (AD), vascular dementia (VD), and mixed dementia.
    • To synthesize evidence from randomized controlled trials to inform clinical practice.

    Main Methods:

    • A systematic search of the Cochrane Dementia and Cognitive Improvement Group Specialized Register and other databases was conducted.
    • Included were double-blind, parallel-group, placebo-controlled, randomized trials of memantine in individuals with dementia.
    • Data were pooled, and both intention-to-treat (ITT) and observed case (OC) analyses were performed.

    Main Results:

    • In moderate to severe AD, memantine demonstrated a small beneficial effect on cognition, activities of daily living, and behavior at six months.
    • A single trial in mild to moderate AD indicated benefits in cognition and behavior, though this requires confirmation due to unpublished data.
    • In mild to moderate vascular dementia, memantine improved cognition and behavior, but global assessments did not consistently support these findings.
    • Patients receiving memantine showed a reduced likelihood of developing agitation, particularly in moderate to severe dementia.
    • Memantine was generally well-tolerated across studies.

    Conclusions:

    • Published evidence suggests a modest benefit of memantine at six months for moderate to severe AD.
    • The cognitive benefits observed in mild to moderate vascular dementia were not consistently reflected in global assessments.
    • The efficacy of memantine in mild to moderate AD remains uncertain due to conflicting or insufficient data.

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