From the FDA Drug Label
Signs and symptoms most often accompanying memantine overdosage in clinical trials and from worldwide marketing experience, alone or in combination with other drugs and/or alcohol, include ... ECG changes ...
The effects of Memantine include ECG changes, as noted in the context of overdosage. 1
From the Research
Memantine does not typically cause significant ECG changes in most patients, and routine ECG monitoring is not typically required solely due to memantine therapy. This NMDA receptor antagonist, commonly used to treat moderate to severe Alzheimer's disease at doses of 5-20 mg daily, has a favorable cardiovascular safety profile compared to many other medications used in elderly populations 2. While isolated case reports have noted rare instances of QT interval prolongation, these occurrences are uncommon and not considered a characteristic effect of the medication. Memantine works by regulating glutamate activity in the brain rather than directly affecting cardiac conduction.
Some studies have investigated the effects of memantine on the QT interval, with a 2021 study finding no clinically significant changes in the QT interval with therapeutic blood levels of memantine 2. Another study in 2022 found that memantine did not induce repolarization delay, indicating a lack of risk for inducing torsade de pointes 3.
Key points to consider when prescribing memantine include:
- Memantine has a favorable cardiovascular safety profile compared to other medications used in elderly populations
- Routine ECG monitoring is not typically required solely due to memantine therapy
- Patients with pre-existing cardiac conditions should still be monitored appropriately when starting memantine
- Memantine works by regulating glutamate activity in the brain rather than directly affecting cardiac conduction
Overall, the available evidence suggests that memantine is a safe and effective treatment option for moderate to severe Alzheimer's disease, with a low risk of significant ECG changes or cardiovascular adverse events 2, 3.