Memantine for cognitive impairment in multiple sclerosis: a randomized placebo-controlled trial

Area of Science:

• Neuroscience
• Clinical Neurology

Background:

• Memantine is an NMDA antagonist approved for moderate to severe Alzheimer's disease.
• Multiple sclerosis (MS) can cause cognitive impairment (CI).

Purpose of the Study:

• To evaluate the efficacy of memantine in improving cognitive performance (CP) in individuals with MS and CI.

Main Methods:

• A double-blind, randomized, placebo-controlled trial (NCT00300716) was conducted.
• Participants received either 10 mg memantine twice daily or a placebo.
• Primary outcomes included changes in the Paced Auditory Serial Addition Test (PASAT) and California Verbal Learning Test-II (CVLT-II) Long Delay Free Recall (LDFR).

Main Results:

• No significant differences in CP were observed between the memantine and placebo groups on the PASAT or CVLT-II LDFR.
• Memantine was associated with increased fatigue and neurological adverse events.
• Caregiver reports indicated less cognitive improvement and more neuropsychiatric symptoms in the memantine group.

Conclusions:

• Memantine at 10 mg twice daily does not enhance cognitive function in adults (18-65) with MS experiencing subjective cognitive complaints and objective cognitive deficits.
• The study population excluded individuals with major depression.
• Further research may be needed to explore other therapeutic strategies for cognitive impairment in MS.