Effectiveness and safety of memantine treatment for Alzheimer's disease
Zhendong Yang1, Xiangyu Zhou, Qi Zhang
1Department of Neurology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background/Objective:
Memantine is approved as a treatment for moderate to severe Alzheimer's disease (AD). However, recent studies report that memantine is harmful for AD patients in several ways. This paper will systematically review all the available studies to provide an update regarding memantine as a treatment for AD.
Method:
Two authors queried nine databases containing literature published prior to September 15, 2012 and determined eligible studies based on the inclusion criteria. We used Review Manager to pool similar data. The Cochrane Handbook was used to assess the bias of the included studies. The chi-squared test, sensitivity analysis, Egger's test, and funnel plots were used to determine the heterogeneity and report bias, respectively.
Result:
We obtained 889 studies and determined that 12 of those studies met the inclusion criteria. The pooled analysis showed that memantine had significant benefits for AD patients in terms of cognition and the clinician's global impression. There were no significant benefits for AD patients in terms of mental state or activities of daily life. The results on brain volume and metabolism were controversial in two of the studies. Memantine did not significantly affect discontinuation caused by serious adverse events but did increase the risk for somnolence, weight gain, confusion, hypertension, nervous system disorders, and falling.
Conclusion:
Memantine is beneficial for AD patients with regards to cognition and clinician's global impression but increases the risk for somnolence, weight gain, confusion, hypertension, nervous system disorders, and falling.
Insights
Memantine benefits Alzheimer's disease (AD) patients' cognition and clinician impression but increases risks for side effects like somnolence and confusion. This review updates memantine treatment efficacy and safety for AD.
Area of Science:
- Neuroscience
- Pharmacology
- Geriatrics
Background:
- Memantine is an approved treatment for moderate to severe Alzheimer's disease (AD).
- Emerging research suggests potential harm associated with memantine in AD patients.
- A systematic review is needed to clarify memantine's current therapeutic profile in AD.
Purpose of the Study:
- To systematically review available literature on memantine's efficacy and safety in Alzheimer's disease treatment.
- To provide an updated assessment of memantine's benefits and risks for AD patients.
Main Methods:
- A comprehensive literature search was conducted across nine databases up to September 15, 2012.
- Eligible studies were identified, and data were pooled using Review Manager.
- Study bias, heterogeneity, and reporting bias were assessed using established methodologies (Cochrane Handbook, chi-squared test, Egger's test, funnel plots).
Main Results:
- Of 889 initial studies, 12 met the inclusion criteria for analysis.
- Memantine demonstrated significant benefits in improving cognition and clinician's global impression in AD patients.
- No significant improvements were observed in mental state or daily living activities; controversial findings emerged regarding brain volume and metabolism.
- While not increasing serious adverse event discontinuation, memantine was associated with increased risks of somnolence, weight gain, confusion, hypertension, nervous system disorders, and falls.
Conclusions:
- Memantine offers benefits for Alzheimer's disease patients concerning cognitive function and overall clinical impression.
- However, its use is linked to an increased risk of adverse events including somnolence, weight gain, confusion, hypertension, neurological issues, and falls.
- This review underscores the need for careful consideration of memantine's risk-benefit profile in AD management.
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