There was a benefit in favour of memantine (10 mg/day) compared with placebo at 12 weeks, for the numbers improved in terms of clinical impression of change (60/82 compared with 38/84 - OR 3.30, 95% CI 1.72 to 6.33, P=0.0003) (Winblad 1999). Memantine for the Treatment of Dementia: A Review on its Current and Future Applications. There were no significant differences between memantine and placebo for the number of drop-outs and total number of adverse effects, but a significant difference in favour of placebo for the number who suffer restlessness. We reviewed the evidence on memantine, which is one of the main drugs for treating people with dementia. To determine the clinical efficacy and safety of memantine for people with Alzheimer's disease, or vascular or mixed dementia. 1. Clinical studies of the safety and efficacy of memantine for other neurological disorders, including glaucoma and other forms of dementia, are currently underway. Medline; Google Scholar. Memantine for dementia Machine translation. We pooled and analysed data from four clinical domains across different aetiologies and severities of dementia and for AD with agitation. Methods Patients (≥50 years of age) with mild to moderate PDD or DLB were recruited from 30 specialist centres in Austria, France, Germany, the UK, Greece, Italy, Spain, and Turkey. doi: 10.1002/14651858.CD003154.pub5. Memantine oral tablet is a prescription medication used to treat moderate to severe dementia caused by Alzheimer’s disease. Therefore, the efficacy and safety of memantine were investigated in patients with mild to moderate Parkinson's disease dementia (PDD) or dementia with Lewy bodies (DLB). There is a small clinical benefit of memantine in people with moderate-to-severe AD, which occurs irrespective of whether they are also taking a ChEI, but no benefit in people with mild AD. Selection criteria: It differs from other licensed dementia medicines in that it is an N-methyl-D-aspartate (NMDA) receptor antagonist. Memantine may be used off-label to provide the same benefit for people with vascular dementia. This causes more damage to the nerve cells. Therapy for Alzheimer's Disease: How Effective are Current Treatments. There is a beneficial effect of memantine (20 mg/day) for patients with moderate to severe Alzheimer disease on cognition and functional decline but … Objectives: To determine efficacy and safety of memantine for people with dementia. These include worsening mental abilities (such as disorientation) and problems carrying out daily activities such as getting dressed. Across all types of dementia, data were available from almost 10,000 participants in 44 included trials, most of which were at low or unclear risk of bias. Memantine is usually well tolerated. Am J Geriatr Psychiatry. It hasbeen found to have a small beneficial effect in moderate-to-severe AD but no significant differences compared with placebo were found in mild AD.5 NICE has approved its use for severe AD, or moderate AD in Memantine hydrochloride should always be initiated and supervised by specialists experienced in the management of dementia. Patients assigned to receive memantine, as compared with those assigned to receive memantine placebo, had a score on the SMMSE that was an average … Most studies were well conducted, but some were not well reported and we got extra information from the drug companies. In vascular dementia, two studies in about 750 people indicated there is probably a small benefit for thinking difficulties, behaviour and mood, and there may be less agitation for memantine compared with placebo. Continuum (Minneapolis Minn). However, when nerve cells are damaged by Alzheimer’s disease, too much glutamate is produced. Mild AD (Mini Mental State Examination (MMSE) 20 to 23): mainly moderate-certainty evidence based on post-hoc subgroups from up to four studies in around 600 participants suggests there is probably no difference between memantine and placebo for CF: 0.21 ADAS-Cog points (95% CI -0.95 to 1.38); performance on ADL: -0.07 ADL 23 points (95% CI -1.80 to 1.66); and BM: -0.29 NPI points (95% CI -2.16 to 1.58). This site needs JavaScript to work properly. Memantine for dementia Memantine is a safe drug and may be useful for treating Alzheimer's, vascular,and mixed dementia of all severities. memantine Hydrochloride Tablets USP is indicated for the treatment of moderate to severe dementia of the Alzheimer’s type. Cochrane Database Syst Rev. 77). 2004 Oct 18;(4):CD003154. You can find out more about our use of cookies in About Cookies, including instructions on how to turn off cookies if you wish to do so. Background: Memantine, a low affinity antagonist to glutamate NMDA receptors, may prevent excitatory neurotoxicity in dementia. It differs from other licensed dementia medicines in that it is an N-methyl-D-aspartate (NMDA) receptor antagonist. There is type I evidence showing small cognitive improvements with both AChE inhibitors and memantine in vascular dementia. Cochrane Database Syst Rev. eHealthMe is studying from 5,215 Memantine users now. memantine hydrochloride was evaluated in eight double-blind placebo-controlled trials involving a total of 1862 dementia (Alzheimer’s disease, vascular dementia) patients (940 patients treated with memantine hydrochloride and 922 patients treated with placebo) for a … The dose should be increased in 5 mg increments to 10 mg/day (5 mg twice daily), 15 mg/day (5 mg and 10 mg as separate doses), and 20 … Memantine is a moderate affinity uncompetitive antagonist of glutamate NMDA receptors. We use cookies to improve your experience on our site. It treats the symptoms of moderate to severe Alzheimer’s disease only and is not a cure – there is no evidence that it can halt or reverse the process of cell damage that causes the disease. To assess whether memantine adds benefit for people already taking cholinesterase inhibitors (ChEIs). Search strategy: The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group was searched on 28 October 2004. Cochrane Database Syst Rev. We transformed results for efficacy outcomes into the difference in points on particular outcome scales. However, treatment may be continued in primary care under a shared-care protocol. doi: 10.1002/14651858.CD003154. 2009 May;2(3):163-80. doi: 10.1177/1756285609102724. Although studies in recent years have demonstrated the positive effects of cholinesterase inhibitors in LBD, the search for therapeutic agents with other mechanisms of action remains relevant. Cochrane Database Syst Rev. and relatives, memantine can be said to be usually well tolerated, and to offer modest benefits for patients with moderate – severe dementia. Memantine produces global improvements in Lewy body dementias, but the pattern of cognitive and neuropsychiatric responsiveness remains uncertain (B) Vascular dementia. However there is a possible benefit on cognition and global measures, an … HHS 1224 J. Folch et al. Memantine reduces the actions of chemicals in the brain that may contribute to the symptoms of Alzheimer's disease. Well absorbed following oral administration of conventional preparations, with peak plasma concentrations attained in about 3–7 hours. 2019 Mar 20;3(3):CD003154. Memantine is licensed for the treatment of moderate to severe Alzheimer’s disease. Memantine isn’t a cholinesterase inhibitor, but it also acts on chemicals in the brain. Double-blind, parallel group, placebo-controlled, randomised trials of memantine in people with dementia. Withdrawal or continuation of cholinesterase inhibitors and/or memantine in patients with dementia. Objectives: To determine efficacy and safety of memantine for people with dementia. We analysed the results separately for people with mild dementia and those with moderate-to-severe dementia. This is mainly moderate-quality evidence. Memantine acts as a neuroprotective agent … You can find out more about medicines like memantine in the separate leaflet called Medicines for Dementia. We examined clinical trials registries, press releases and posters of memantine manufacturers; and the web sites of the FDA, EMEA and NICE. Glutamate is another chemical that helps to send messages between nerve cells in the brain. NCT00630500: Efficacy and Safety of Memantine for Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB) Objectives: To determine efficacy and safety of memantine for people with Alzheimer's disease (AD), vascular (VD) and mixed dementia. There is high-certainty evidence showing no difference between memantine and placebo in the proportion experiencing at least one adverse event: RR 1.03 (95% CI 1.00 to 1.06); the RR does not differ between aetiologies or severities of dementia. doi: 10.1002/14651858.CD003154.pub6. There were no significant differences between memantine and placebo for the number of drop-outs and total number of adverse effects, but a significant difference in favour of memantine for the number who suffer agitation. 2006 Apr 19;(2):CD003154. It isn’t a cure (there is no cure for Alzheimer’s or related dementias) but studies have shown memantine treats symptoms by improving memory, awareness, and concentration. Background: Memantine, a low affinity antagonist to glutamate NMDA receptors, may prevent excitatory neurotoxicity in dementia. Memantine oral tablet is a prescription medication used to treat moderate to severe dementia caused by Alzheimer’s disease. Mild-to-moderate vascular dementia. Memantine may be used off-label to provide the same benefit for people with vascular dementia. It differs from other licensed dementia medicines in that it is an N-methyl-D-aspartate (NMDA) receptor antagonist. doi: 10.1002/14651858.CD003154.pub3. This plain language summary is up to date as of March 2018. We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's register of trials (http://www.medicine.ox.ac.uk/alois/) up to 25 March 2018. The rationale for use is excitotoxicity as a pathomechanism of neurodegenerative disorders. Overall, it is well tolerated in those with moderate--to-severe AD, but it may cause dizziness in a few of the people taking it. Memantine Memantine is also used to treat the cognitive deficits of AD and is licensedfor moderate-to-severe dementia inAD. Most studies (29 in 7885 people) were in people with AD. This medicine (also known as Namenda) is given to people with moderate or severe Alzheimer's disease, dementia with Lewy bodies and those with a combination of Alzheimer's disease and vascular dementia. These drugs work differently and we wanted to find out whether giving the two drug types together would work better than the ChEI drugs on their own. Clinical heterogeneity in AD makes it unlikely that any single drug will have a large effect size, and means that the optimal drug treatment may involve multiple drugs, each having an effect size that may be less than the minimum clinically important difference. Effect of memantine in patients with mild to moderate vascular dementia: analysis of the change from baseline at 28 weeks gave statistically significant results in favour of memantine ( 20 mg/day ) for cognition (MD ‐2.19, 95% CI ‐3.16 to ‐1.21, P<0.0001) but there was no benefit for the clinical impression of change, or for global measures of dementia (MMM300, and MMM500). What is memantine? Background: Memantine, a low affinity antagonist to glutamate NMDA receptors, may prevent excitatory neurotoxicity in dementia. There are two main types of treatment: acetyl cholinesterase inhibitor (ChEI) drugs and memantine. Memantine Versus Placebo in Parkinson’s Disease Dementia or Dementia with Lewy Bodies: The purpose of this study is to determine if MEM can provide benefits on clinical symptoms in patients with PD dementia or DLB. Lewy body dementia (LBD) is a progressive brain disease manifest as dementia and parkinsonism, along with psychotic and autonomic disorders. We found 44 studies involving about 10,000 people. 2015 Nov 30;16(12):28401-17. doi: 10.3390/ijms161226099. It is often used in alzheimer's disease. Memantine, commonly prescribed in the United States under the brand name Namenda, is for people with moderate-to-severe Alzheimer’s disease and vascular dementia. What is Dementia? [Cholinesterase inhibitors for rarer dementia associated with neurological conditions], Cholinesterase inhibitors are beneficial for people with Parkinson's disease and dementia, Cholinesterase inhibitors for vascular dementia and other vascular cognitive impairments: a network meta-analysis, Interventions aimed at interrupting disease processes, Treatment aimed at interrupting disease processes. Search strategy: ... Memantine for dementia. Memantine protects nerve cells by blocking the effects of too much glutamate. Dies ist nicht die neueste Version dieses Dokuments Sehen Sie sich die neueste Version. Objectives: To determine efficacy and safety of memantine for people with Alzheimer's disease (AD), vascular (VD) and mixed dementia. Memantine is well tolerated. Our health evidence - how can it help you.  |  Severe Dementia. In a first analysis, patients were stratified by their severity of dementia (measured by the MMSE total scores at baseline). A long-duration trial in moderate-to-severe AD is needed to establish whether the benefit persists beyond six months. Memantine is prescribed for people who have dementia which is associated with Alzheimer's disease. It is licensed for use in moderate and severe Alzheimer's disease (AD); in the USA, it is also widely used off-label for mild AD. We also wanted to know if adding memantine to other dementia drugs gives an extra effect. Memantine has a small beneficial effect in people with moderate-to-severe AD. Dementia (madness) has been reported by people with parkinson's disease, osteoporosis, high blood pressure, multiple sclerosis, rheumatoid arthritis. All major health care databases and trial databases within the scope of the group are searched regularly to keep this Register up to date. Quality of the evidenceOverall, the evidence on memantine for AD is high quality, and comes from many trials in thousands of people. In this analysis, memantine was superior to placebo in all subgroups, but the magnitude of effect was clearly more pronounced in the more severely demented patients. There is limited, mainly low- or very low-certainty efficacy evidence for other types of dementia (Parkinson's disease and dementia Lewy bodies (for which CGR may show a small clinical benefit; four studies in 319 people); frontotemporal dementia (two studies in 133 people); and AIDS-related Dementia Complex (one study in 140 people)). Objectives: The recommended starting dose of memantine Hydrochloride Tablet is 5 mg once daily. It is used to help the symptoms which affect thinking, such as memory loss and confusion. Moderate-to-severe AD (with or without concomitant ChEIs). Effect of memantine in patients with moderate to severe Alzheimer's disease: analysis of the change from baseline at 28 weeks gave statistically significant results in favour of memantine for 20 mg/day on cognition (MD: 6.1. McShane R, Westby MJ, Roberts E, Minakaran N, Schneider L, Farrimond LE, Maayan N, Ware J, Debarros J. Cochrane Database Syst Rev. Memantine is used to treat moderate to severe dementia of the Alzheimer's type. Cholinesterase inhibitors may be added to memantine for further beneficial effects on behavioral symptoms and other symptoms of dementia [A177106]. We assessed the impact of study duration, severity and concomitant use of ChEIs. 2. Acerca de However, when nerve cells are damaged by Alzheimer’s disease, too much glutamate is produced. Memantine (compared with placebo) may increase the numbers of people discontinuing treatment because of adverse events (RR 2.12, 95% CI 1.03 to 4.39). We contacted authors and companies for missing information. No. Cochrane Database Syst Rev. It is licensed for use in moderate and severe Alzheimer's disease (AD); in the USA, it is also widely used off-label for mild AD. Although there is moderate-certainty evidence that fewer people taking memantine experience agitation as an adverse event: RR 0.81 (95% CI 0.66 to 0.99) (25 fewer people per 1000, 95% CI 1 to 44 fewer), there is also moderate-certainty evidence, from three additional studies, suggesting that memantine is not beneficial as a treatment for agitation (e.g. / Memantine for the Treatment of Dementia results. Effect of memantine in patients with Alzheimer's disease and vascular dementia at 12 weeks: there was no statistically significant difference between memantine (10 mg/day) and placebo in activities of daily living. About one or two people in 100 have AD at age 65, and this rate doubles every five years. 1 4 Tablets and oral solution are equivalent on a mg-per-mg basis. Memantine is suitable for those who cannot take or are unable to tolerate acetylcholinesterase inhibitors. You can find out more about medicines like memantine in the separate leaflet called Medicines for Dementia. Memantine improves global function in people with Alzheimer's disease, vascular and mixed dementia of all severities . It helps reduce dementia symptoms, but it … McShane R, Westby MJ, Roberts E, Minakaran N, Schneider L, Farrimond LE, Maayan N, Ware J, Debarros J, McShane R, Westby MJ, Roberts E, Minakaran N, Schneider L, Farrimond LE, Maayan N, Ware J, Debarros J. Memantine for dementia. Trials were identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 15 April 2003 using the terms: memantin*, D-145, DMAA, DRG-0267. Memantine works differently from donepezil, rivastigmine and galantamine. A few studies have shown the drug to be effective in decreasing symptoms of … Memantine (Ebixa--Lundbeck Ltd), an oral medicine, is available in the UK for treating "patients with moderately severe to severe Alzheimer's disease". We wanted to find out if memantine can slow down the course of dementia and if it is harmful in any way. What is memantine? DOI: 10.1002/14651858.CD003154.pub6, Copyright © 2021 The Cochrane Collaboration.  |  This drug should not be on the market. This medicine (also known as Namenda) is given to people with moderate or severe Alzheimer's disease, dementia with Lewy bodies and those with a combination of Alzheimer's disease and vascular dementia. memantine Dosage and Administration. INTERPRETATION: There is a striking absence of evidence about pharmacological treatment of cognitive impairment and dementia in people older than 40 years with Down's syndrome. Effect of memantine in patients with mild to moderate vascular dementia: analysis of the change from baseline at 28 weeks gave statistically significant results in favour of memantine ( 20 mg/day ) for cognition (MD ‐2.19, 95% CI ‐3.16 to ‐1.21, P<0.0001) but there was no benefit for the clinical impression of change, or for global measures of dementia (MMM300, and MMM500). Memantine, a non-competitive NMDA antagonist, has been approved for use in the treatment of dementia in Germany for over ten years. Clipboard, Search History, and several other advanced features are temporarily unavailable. An open, controlled, 16-week study was performed … 6 Matsunaga S, Kishi T and Iwata N: Memantine for Lewy body disorders: Systematic review and meta-analysis. 15 17 Following multiple-dose administration of extended-release capsules, peak concentrations achieved in about 9–12 hours. A low affinity antagonist to N-Methyl-D-aspartate (NMDA) type receptors, such as memantine, may prevent excitatory amino acid neurotoxicity without interfering with the physiological actions of glutamate required for memory and learning. Memantine is approved for use for people with moderate to severe Alzheimer’s disease. There is a possible beneficial effect on cognition, function and global scales for memantine at 6 weeks in mixed populations. View Article: Google Scholar: PubMed/NCBI. Studies show that memantine can curb delusions, hallucinations, agitation, aggression, and irritability that can happen with dementia. An important result is that adding memantine to established ChEI treatment also results in less deterioration than placebo. NLM Clin Med (Lond). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Double-blind, parallel group, placebo-controlled, randomized and unconfounded trials in which memantine was administered to people with dementia. Memantine. Effect of memantine in patients with vascular dementia, Alzheimer's disease and dementia of non-specified type at 6 weeks: there were beneficial effects on cognition (Ditzler 1991), activities of daily living (Ditzler 1991, Pantev 1993), behaviour (Pantev 1993) and global scales (Gortelmeyer 1992; Pantev 1993; Ditzler 1991) and in global impression of change (Gortelmeyer 1992; Ditzler 1991). 4 ): a randomised, double-blind, parallel group, placebo-controlled trial (. Established ChEI treatment also results in less deterioration than placebo of Alzheimer 's:! Concentrations attained in about 3–7 hours dementia which is associated with Alzheimer 's disease History, and extremely confused,! Are two main types of treatment: acetyl cholinesterase inhibitor, but it memantine!, followed by vascular dementia improve your experience on our site 5'-Diphosphocholine Citicoline... 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