Efficacy and Safety of Memantine in Moderate-to-Severe Alzheimer Disease: The Evidence to Date
Abstract
Memantine, a moderate-affinity, uncompetitive N-methyl-D-aspartate receptor antagonist, is currently the only agent approved for moderately severe to severe Alzheimer disease (AD) in Europe and for moderate-to-severe Alzheimer disease in the United States. In clinical trials, memantine has consistently demonstrated a reduced rate of deterioration on global, cognitive, functional, and behavioral measures, across a range of outcome measures compared with usual care. Notably, improvements versus placebo were seen in individual activities of daily living and behavior, particularly agitation. Efficacy was demonstrated in patients with newly diagnosed Alzheimer disease, patients previously or currently receiving acetylcholinesterase inhibitors, and both institutionalized and community-dwelling Alzheimer disease patients. Memantine has a tolerability profile similar to placebo. This review presents the results of key clinical trials, and includes clinically relevant analyses, such as numbers-needed-to-treat and effect sizes. Increased dependency and institutionalization are significant cost drivers in Alzheimer disease. Memantine is able to reduce dependency, caregiver time required, and mean monthly caregiver and societal costs. Recent studies of the relationship between Alzheimer disease progression, caregiver burden, and healthcare costs emphasize the need for treatments such as memantine that can slow the rate of decline in Alzheimer disease.
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Memantine reduces the rate of decline in behavioral and functional impairment in patients with moderate to severe Alzheimer's disease.
“The rate of decline in behavioral and functional impairment in patients with moderate to severe AD is reduced by memantine [34].”
From Indian Medicinal Herbs and Formulations for Alzheimer’s Disease, from Traditional Knowledge to Scientific Assessment (2020) · cites this paper as [34]
In moderate and severe AD, short-term efficacy of memantine monotherapy compared with placebo is reported in several randomized controlled trials of 12 to 50 weeks duration and supported by meta-analyses.
“In moderate and severe AD, short-term efficacy of memantine monotherapy compared with placebo is reported in several RCTs of 12 to 50 weeks duration and supported by meta-analyses.”
From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [101]
Memantine treatment benefits include improvement, stabilization, or reduced decline in cognition, function (activities of daily living), and global status, and amelioration of behavioral and psychological symptoms of dementia and caregiver burden.
“Treatment benefits include improvement, stabilization, or reduced decline in the domains of cognition, function (ADLs), and global status; and by amelioration of BPSD and caregiver burden.63,71,73,[98][99][100][101][102][103][104][105][106][107][108][109][110][111]”
From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [101]
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“The rate of decline in behavioral and functional impairment in patients with moderate to severe AD is reduced by memantine [34].”
BackgroundLiu, H.-P., Lin, W.-Y., Liu, S.-H., Wang, W.-F., Tsai, C.-H., Wu, B.-T., Wang, C.-K., & Tsai, F.-J. (2009) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000254757 · Cited by 29 · see citing works
- Authors
- Bullock, R.
- Corresponding author
- Bullock, Roger
- Venue
- Alzheimer Disease & Associated Disorders
- Published
- 2006-01
- Volume
- 20
- Issue
- 1
- Pages
- 23-29
- ISSN
- 0893-0341 (ISSN-L)
- OpenAlex
- W1975743278
- Cited by
- 89
- References
- 47
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 6 · 2018: 2 · 2017: 5 · 2016: 7 · 2015: 2 · 2014: 4 · 2013: 4 · 2012: 3
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alzheimer Disease & Associated Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Keywords
- memantine, Alzheimer's disease, NMDA receptor antagonists, disease progression, functional decline, agitation, activities of daily living, acetylcholinesterase inhibitors, caregiver burden, health care costs, institutionalization, number needed to treat, drug safety
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Alzheimer Disease, Cost-Benefit Analysis, Female, Humans, Institutionalization, Male, Memantine, Middle Aged, Neuropsychological Tests, Psychometrics, Randomized Controlled Trials as Topic, Receptors, N-Methyl-D-Aspartate, Treatment Outcome, Caregivers, Cost of Illness, Disease Progression, Excitatory Amino Acid Antagonists, Nootropic Agents
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