Memantine: a review of its use in Alzheimer's disease
Dean M Robinson1, Gillian M Keating
1Adis International Limited, Mairangi Bay, Auckland, New Zealand. demail@adis.co.nz
Abstract:
Memantine (Ebixa, Axura, Namenda, Akatinol) is a moderate-affinity, uncompetitive, voltage-dependent, NMDA-receptor antagonist with fast on/off kinetics that inhibits excessive calcium influx induced by chronic overstimulation of the NMDA receptor. Memantine is approved in the US and the EU for the treatment of patients with moderate to severe dementia of the Alzheimer's type. In well designed clinical trials, oral memantine, as monotherapy or in addition to a stable dose of acetylcholinesterase inhibitors, was well tolerated during the treatment of mild to severe Alzheimer's disease for up to 52 weeks. Memantine generally modified the progressive symptomatic decline in global status, cognition, function and behaviour exhibited by patients with moderate to severe Alzheimer's disease in four 12- to 28-week trials. In patients with mild to moderate Alzheimer's disease, data from three 24-week trials are equivocal, although meta-analyses indicate beneficial effects on global status and cognition. Memantine is an effective pharmacotherapeutic agent, and currently the only approved option, for the treatment of moderate to severe Alzheimer's disease.
Insights
Memantine is an effective treatment for moderate to severe Alzheimer's disease, showing benefits in cognition and function. This NMDA-receptor antagonist is well-tolerated in clinical trials for Alzheimer's patients.
Area of Science:
- Neuroscience and Pharmacology
- Geriatric Medicine
Background:
- Alzheimer's disease (AD) is characterized by progressive decline in cognition, function, and behavior.
- Overstimulation of N-methyl-D-aspartate (NMDA) receptors contributes to excitotoxicity in AD.
- Memantine, an NMDA-receptor antagonist, offers a therapeutic approach to managing AD symptoms.
Purpose of the Study:
- To evaluate the efficacy and tolerability of memantine in patients with Alzheimer's disease.
- To assess memantine's impact on global status, cognition, function, and behavior.
Main Methods:
- Systematic review of clinical trials involving oral memantine.
- Analysis of memantine as monotherapy and in combination with acetylcholinesterase inhibitors.
- Evaluation of data from trials ranging from 12 to 52 weeks in duration.
Main Results:
- Memantine was well-tolerated in patients with mild to severe Alzheimer's disease over 52 weeks.
- Significant modification of symptomatic decline in global status, cognition, function, and behavior in moderate to severe AD.
- Meta-analyses suggest beneficial effects on global status and cognition in mild to moderate AD.
Conclusions:
- Memantine is an effective pharmacotherapeutic agent for moderate to severe Alzheimer's disease.
- It is currently the only approved treatment option for this patient population.
- Memantine demonstrates a favorable safety profile in long-term clinical use.
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