From the FDA Drug Label
Patients / caregivers should be instructed to follow the dose titration schedule provided by their physician or healthcare professional for memantine hydrochloride. For patients randomized to memantine hydrochloride, treatment was initiated at 5 mg once daily and increased to 10 mg once daily after 1 week.
The protocol for titrating Memantine upward is to follow the dose titration schedule provided by the physician or healthcare professional. In one study, treatment was initiated at 5 mg once daily and increased to 10 mg once daily after 1 week 1.
From the Research
Memantine should be titrated up gradually over 4 weeks to reach the target dose of 20 mg daily, with a recommended titration schedule of Week 1: 5 mg once daily, Week 2: 5 mg twice daily (10 mg total), Week 3: 15 mg daily (5 mg in the morning, 10 mg in the evening), and Week 4 and onwards: 10 mg twice daily (20 mg total) 2. This gradual titration helps minimize side effects such as dizziness, confusion, and headache, as reported in a study on the side effects of approved antidementives 3. Memantine works by regulating glutamate activity in the brain, which can improve cognitive function in Alzheimer's disease, and the slow increase allows the brain to adjust to the medication's effects. Some key points to consider when titrating memantine upward include:
- Taking memantine with or without food at the same times each day
- If a dose is missed, skipping it and taking the next dose as scheduled, and not doubling up on doses
- Monitoring for improvements in cognitive function and any adverse effects during the titration period and beyond
- For patients with moderate renal impairment, the maximum dose should be limited to 10 mg daily, and severe renal impairment may require further dose reduction The most recent study on memantine, published in 2023, found that it was well-tolerated and consistently taken by a large majority of patients receiving breast cancer chemotherapy, with the majority demonstrating stable or improved cognition from pre- to post-assessment 2. Other studies have also explored the use of memantine in various psychiatric disorders, including autism spectrum disorder, binge eating disorder, and attention-deficit/hyperactivity disorder, with some promising results 4. However, the primary focus of memantine treatment remains the management of Alzheimer's disease, and the titration schedule should be tailored to individual patient needs and response to treatment.