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Memantine for dementia.
Abstract
Background Memantine is a moderate affinity uncompetitive antagonist of glutamate NMDA receptors. 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. Objectives To determine efficacy and safety of memantine for people with dementia. To assess whether memantine adds benefit for people already taking cholinesterase inhibitors (ChEIs). Search methods 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. We examined clinical trials registries, press releases and posters of memantine manufacturers; and the web sites of the FDA, EMEA and NICE. We contacted authors and companies for missing information. Selection criteria Double-blind, parallel group, placebo-controlled, randomised trials of memantine in people with dementia. Data collection and analysis We pooled and analysed data from four clinical domains across different aetiologies and severities of dementia and for AD with agitation. We assessed the impact of study duration, severity and concomitant use of ChEIs. Consequently, we restricted analyses to the licensed dose (20 mg/day or 28 mg extended release) and data at six to seven months duration of follow-up, and analysed separately results for mild and moderate-to-severe AD.We transformed results for efficacy outcomes into the difference in points on particular outcome scales. Main results Across all…
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“Memantine, an N-methyl-D-aspartate (NMDA) receptor antagonist, helps regulate glutamate and is beneficial in moderate to severe AD, improving global functioning, cognition, and daily activities.28,29”
From A 2025 update on treatment strategies for the Alzheimer’s disease spectrum (2025) · cites this paper as [28]
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Metadata
- Authors
- McShane, R., Westby, M. J., Roberts, E., Minakaran, N., Schneider, L., Farrimond, L. E., Maayan, N., Ware, J., & Debarros, J.
- Affiliations
- John Radcliffe Hospital (GB)
- Manchester Academic Health Science Centre (GB)
- King's College London (GB)
- Moorfields Eye Hospital NHS Foundation Trust (GB)
- University of Southern California (US)
- Cochrane (GB)
- University of Oxford (GB)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2019-03-20
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- OpenAlex
- W4211051557
- Cited by
- 310
- References
- 214
- Citations by year
- 2026: 36 · 2025: 36 · 2024: 53 · 2023: 52 · 2022: 53 · 2021: 41 · 2020: 25 · 2019: 14
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- Funders
- National Institute for Health and Care Research (13/89/22)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pharmacology (medical) › Cholinesterase and Neurodegenerative Diseases
- Keywords
- memantine, dementia, Alzheimer's disease, NMDA receptor antagonists, cholinesterase inhibitors, combination therapy, cognitive function, activities of daily living, functional status, agitation, off-label drug use, drug safety, adverse events, mild Alzheimer's disease, risk of bias, publication bias, sustained-release formulation, long-term follow-up
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