Is memantine a breakthrough in the treatment of moderate-to-severe Alzheimer's disease?
Over stimulation of the NMDA receptor by glutamate has long been considered to have a role in Alzheimer's disease (AD). Memantine, a non-competitive antagonist of NMDA receptors, has recently been tested in moderate-to-severe AD. At 28 weeks, there was a small significant mean difference of 0.3 in favour of memantine, showing benefit in the Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-Plus) global score. The other primary efficacy variable was the Alzheimer's disease Cooperative Study Activities of Daily Living Inventory, modified for more severe dementia (ADCS-ADL-sev) and there was significantly less deterioration in the ADCSADL-sev score in the memantine group than in the placebo group (2.1 versus 3.4, respectively). As there are no drugs commonly used for their effectiveness in moderate-to-severe AD, any drug that causes a benefit, however small, as memantine has been shown to do in this trial, represents a breakthrough.
Doggrell
Sheila
S
Doggrell Biomedical Communications, 47 Caronia Crescent, Lynfield, Auckland, New Zealand. s_doggrell@yahoo.co
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000378:metabolism; D002986:Clinical Trials as Topic; D006801:Humans; D008559:Memantine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D016194:Receptors, N-Methyl-D-Aspartate; D008559:Memantine