From the Guidelines
Namenda (Memantine) is used to treat moderate to severe Alzheimer's disease and has shown some benefit in patients with mild to moderate vascular dementia.
Key Points
- Memantine works by partially blocking the N-methyl-d-aspartic acid receptor and preventing excess stimulation of the glutamate system, which influences memory and learning 1.
- The FDA has approved memantine for the treatment of moderate to severe Alzheimer's disease, and it has been shown to result in statistically significant, but not clinically important, improvement on the ADAS-cog scale in cognition for individuals with mild to moderate vascular dementia and mild to moderate Alzheimer's disease 1.
- Studies have also found that memantine can improve behavior, quality of life, and caregiver burden in patients with Alzheimer's disease, with a dosage of 20 mg/d 1.
- The withdrawal rates related to adverse effects of memantine varied from 9% to 12% in the treatment group, including nausea, dizziness, and other gastrointestinal problems 1.
Important Considerations
- Memantine is not a cure for Alzheimer's disease, but it can help alleviate symptoms and slow disease progression 1.
- The choice of pharmacologic agents for the treatment of dementia should be based on tolerability, adverse effect profile, ease of use, and cost of medication, as the evidence is insufficient to compare the effectiveness of different pharmacologic agents 1.
From the FDA Drug Label
Memantine hydrochloride is an N-methyl-D-aspartate (NMDA) receptor antagonist indicated for the treatment of moderate to severe dementia of the Alzheimer’s type. Memantine hydrochloride oral solution is a prescription medicine used for the treatment of moderate to severe dementia in people with Alzheimer’s disease.
Namenda (Memantine) is used for the treatment of moderate to severe dementia of the Alzheimer’s type 2. The main indication is for patients with Alzheimer’s disease 2.
- Key uses: Treatment of moderate to severe dementia in people with Alzheimer’s disease.
- Mechanism of action: N-methyl-D-aspartate (NMDA) receptor antagonist.
From the Research
Uses of Namenda (Memantine)
- Namenda (Memantine) is used for the treatment of moderate to severe Alzheimer's disease 3, 4, 5, 6
- It is also used for the treatment of vascular dementia and Parkinson's disease, although the evidence for these uses is less robust 3
- Memantine has been shown to have a small clinical benefit in people with moderate-to-severe Alzheimer's disease, but no benefit in people with mild Alzheimer's disease 7
- It is used as monotherapy or in combination with acetylcholinesterase inhibitors, such as donepezil, to improve outcomes in patients with moderate to severe Alzheimer's disease 5, 6
Mechanism of Action
- Memantine is a moderate-affinity, uncompetitive, voltage-dependent, NMDA-receptor antagonist that inhibits excessive calcium influx induced by chronic overstimulation of the NMDA receptor 5
- It has a distinct mode of action compared to acetylcholinesterase inhibitors, and its use in combination with these agents may provide additional benefits 6
Efficacy and Safety
- Memantine has been shown to be effective in modifying the progressive symptomatic decline in global status, cognition, function, and behavior in patients with moderate to severe Alzheimer's disease 4, 5
- It is generally well tolerated, with adverse events occurring with a similar incidence to that reported with placebo 5, 6
- The most common adverse events associated with memantine include dizziness, headache, and confusion 7