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Behavioral effects of memantine in Alzheimer disease patients receiving donepezil treatment

Jeffrey L Cummings1, Eugene Schneider, Pierre N Tariot

  • 1Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1769, USA. jcummings@mednet.ucla.edu

Neurology
|July 13, 2006
PubMed
Abstract

Insights

Memantine significantly improved behavioral symptoms in Alzheimer disease (AD) patients, reducing agitation, aggression, and appetite issues. It also lowered caregiver distress related to agitation.

Area of Science:

  • Neuroscience
  • Gerontology
  • Pharmacology

Background:

  • Alzheimer disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and behavioral disturbances.
  • Managing behavioral symptoms in moderate to severe AD is crucial for patient well-being and caregiver support.
  • Existing treatments often have limited efficacy or significant side effects, necessitating further research into novel therapeutic strategies.

Purpose of the Study:

  • To evaluate the behavioral effects of memantine in patients with moderate to severe Alzheimer disease (AD).
  • To assess the impact of memantine on specific behavioral domains, including agitation, aggression, and appetite disturbances.
  • To explore the relationship between behavioral changes and global, cognitive, and functional measures.

Main Methods:

  • A 24-week, double-blind, placebo-controlled trial was conducted involving patients with moderate to severe AD on stable donepezil treatment.
  • The Neuropsychiatric Inventory (NPI) was used to assess behavioral effects at baseline, week 12, and week 24.
  • Intent-to-treat analysis was performed using last-observation-carried-forward and observed-cases approaches.

Main Results:

  • Memantine treatment resulted in significantly lower overall NPI scores compared to placebo.
  • Significant improvements were observed in agitation/aggression, eating/appetite, and irritability/lability domains.
  • Memantine reduced existing agitation/aggression and delayed its onset in previously unaffected patients, also decreasing caregiver distress.

Conclusions:

  • Memantine effectively reduces behavioral disturbances in moderate to severe Alzheimer disease (AD), particularly agitation, aggression, and appetite issues.
  • The drug demonstrates efficacy in both alleviating existing symptoms and preventing the emergence of agitation.
  • These findings suggest memantine as a valuable therapeutic option for managing behavioral symptoms in AD patients.

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