Efficacy and adverse effects of memantine treatment for Alzheimer's disease from randomized controlled trials

Area of Science:

• Neurology
• Pharmacology
• Geriatrics

Background:

• The efficacy of memantine for Alzheimer's disease (AD) treatment remains debated.
• Clinical trials have reported high dropout rates and adverse events.
• Effective AD treatments are scarce, necessitating a review of existing evidence.

Purpose of the Study:

• To re-evaluate the evidence for memantine's role in Alzheimer's disease treatment.
• To analyze randomized controlled trials (RCTs) assessing memantine's benefits and risks.

Main Methods:

• Systematic review of 13 randomized controlled trials (RCTs) from eight databases, published before December 31, 2013.
• Extracted and analyzed trial methods, participant characteristics, outcomes (cognition, mental state, daily activities, global impression), and adverse events.
• Utilized Review Manager 5.2 for data analysis.

Main Results:

• Memantine therapy demonstrated significant improvements in cognition (MMSE, SIB), mental state (NPI), activities of daily living (ADCS-ADL19), and clinician's global impression (CIBIC-Plus).
• No significant increase in overall adverse events, serious adverse events, or mortality was observed.
• A notable increase in the risk of somnolence was associated with memantine treatment.

Conclusions:

• Memantine offers significant therapeutic benefits for Alzheimer's disease patients across multiple domains.
• While generally well-tolerated, increased somnolence is a key adverse event to monitor.
• The findings support the continued consideration of memantine as a treatment option for AD, despite prior controversies.