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Will Memantine Exacerbate Seizures in People With Epilepsy? A Prospective Cohort Study
Peiyu Wang1, Lu Lu1, Hui Gao1
1Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.
Annals of Clinical and Translational Neurology
|November 25, 2025
Summary
Add-on memantine did not worsen seizures in people with epilepsy. This study found memantine well tolerated, with similar seizure control and adverse events compared to no memantine. Further trials are needed.
Area of Science:
- Neurology
- Pharmacology
Background:
- Epilepsy is a chronic neurological disorder characterized by recurrent seizures.
- Cognitive impairment is common in epilepsy, and memantine is used to treat cognitive deficits.
- Concerns exist regarding memantine's potential to exacerbate seizures in epilepsy patients.
Purpose of the Study:
- To investigate the safety of add-on memantine in people with epilepsy and cognitive impairment.
- To evaluate whether memantine exacerbates seizures or increases seizure frequency.
Main Methods:
- Prospective cohort study of 211 participants with epilepsy and cognitive impairment.
- Participants were followed for at least 24 weeks.
- Compared seizure outcomes and adverse events between those taking memantine and those not.
Main Results:
- No new-onset bilateral tonic-clonic seizures were observed in either group.
- Increased seizure frequency (≥25%) was reported by 6% of participants (7 in memantine group, 5 in non-memantine group).
- Memantine group reported common adverse events like headache and dizziness; 24-week retention rate was 91%.
Conclusions:
- Adjunctive memantine appears well tolerated in people with epilepsy regarding seizure control and adverse events.
- Previous safety concerns regarding memantine in epilepsy may be disproportionate.
- Larger randomized trials are necessary to confirm these findings and explore memantine's efficacy in epilepsy.
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