Memantine: Part 2

Does memantine really work?

There have been several double blind studies (meaning the patient does not know what he/she is taking and neither does the doctor- evaluations are done by an independent investigator).

For moderate to severe Alzheimer’s disease, 2/3 studies showed a small benefit at 6 months. there was mild improvement in cognition, improved daily living activities and behavior. For mild to moderate AD, there was no improvement seen with memantine. In those individuals with mild to moderate vascular induced dementia, memantine at 6 months only a small benefit in behavior and cognition. Overall, patients taking memantine were slightly less likely to develop agitation. There are no long-term studies to see if the effects of memantine are sustained.

Does the drug have side effects?

In general, memantine is well tolerated. Side effects include constipation, confusion agitation, drowsiness, headache, insomnia, hallucinations, increased libido and cystitis. These side effects are reported to occur in less than 5% of individuals at low doses. When the dose is increased, side effects also increase.

Memantine does not cure Alzheimer’s, it does not slow progression of disease, nor does it reverse any deterioration that has already occurred. It just decreases symptoms.

Namenda is available as a tablet and a liquid. It is usually started at 5 mg twice a day. One must always wait at least 7-10 days before increasing the dose. Most people find that Namenda at 10 mg twice a day works best. The maximum dose of memantine is 20 mg twice a day. The drug does not require any type of laboratory monitoring.