Memantine
Memantine is a non-competitive NMDA receptor antagonist primarily used in the treatment of Alzheimer's disease. It works by regulating the activity of glutamate, a neurotransmitter involved in learning and memory. Memantine helps in reducing symptoms of moderate to severe Alzheimer's disease by improving cognitive function and slowing the progression of the disease.
- Recommended Usage
Indications:
- Alzheimer’s Disease: Memantine is used to treat moderate to severe Alzheimer's disease, improving memory, attention, and the ability to perform daily activities.
- Dementia: Occasionally prescribed for other forms of dementia, though it is primarily approved for Alzheimer’s.
Dosage and Administration:
- Starting dose: The typical starting dose is 5 mg once daily.
- Titration: The dose is usually increased by 5 mg increments each week, depending on patient tolerance.
- Maintenance dose: The usual effective dose is 10 mg twice daily (20 mg total per day).
- Memantine is available in oral tablets, oral solution, and extended-release formulations.
Precautions:
- Renal impairment: Dose adjustments are required for patients with renal impairment (e.g., those with moderate to severe kidney disease).
- CNS effects: Memantine can cause dizziness, headache, and confusion. Caution is advised when performing activities requiring alertness.
- Severe liver disease: Use with caution in patients with severe liver impairment, although there is no specific dose adjustment for mild to moderate liver impairment.
- Pregnancy and breastfeeding: Memantine is classified as Category B (no evidence of harm in animal studies) but should only be used during pregnancy if clearly needed. It is not known if memantine passes into breast milk.
Contraindications:
- Hypersensitivity to memantine or any of its components.
- Severe renal impairment (CrCl < 5 mL/min): Avoid use in patients with severe kidney dysfunction unless adjusted doses are used.
Key Benefits:
- Improves cognition: Helps improve symptoms related to memory, attention, and daily functioning in patients with moderate to severe Alzheimer's disease.
- Slows disease progression: While it doesn't cure Alzheimer's, it can slow the progression of symptoms, allowing patients to maintain their independence longer.
- Well-tolerated: Generally, memantine has fewer side effects compared to other Alzheimer's treatments.
