Memantine for dementia in people with Down syndrome.
BACKGROUND
Alzheimer's dementia (AD) is the most common form of dementia in people with Down Syndrome (DS). There is an understanding that an increase in L-glutamate contributes to the pathogenesis of cerebral ischemias and AD. Memantine acts as an antagonist of N-methyl-D-aspartate (NMDA) type receptors, which is thought to reduce abnormal activation of glutamate neurotransmission. It binds with a low affinity to the NMDA receptor and so should not prevent learning and the formation of memory. Memantine can improve cognitive function and slow the decline of AD in the general population over time, and is the subject of this review. It is important to note that people with DS tend to present with AD at a much younger age than the normal population as well as having subtle differences in physiology (e.g. metabolism and heart rate) and may therefore have different requirements from the general population.


OBJECTIVE
To determine the effectiveness and safety of memantine for people with DS who develop AD.


METHODS
CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, BIOSIS, SCI, SSCI and the NRR were searched up to October 2008. We contacted the manufacturers of memantine, as well as experts in the field, to ask about reports of unpublished or ongoing trials.


METHODS
Randomised controlled trials of participants with DS and AD in which treatment with memantine was administered compared with a placebo group.


METHODS
No study was identified which met the inclusion criteria for this review.


RESULTS
No study was identified which met inclusion criteria for this review, however there is an on-going randomised controlled study being conducted in the UK and data are expected in 2009.


CONCLUSIONS
As there are no included trials, recommendations cannot be made about memantine for AD in DS. Well-designed, adequately powered studies are required.
Mohan
Monica
M
Department of Neuropsychiatry, Neuropsychology and Epileptology, Burden Centre, North Bristol Trust, Frenchay Hospital, Bristol, Avon, UK, BS16 1JB. drmonicamohan@yahoo.co.uk
Bennett
Cathy
C
Carpenter
Peter K
PK
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000209:etiology; D004314:Down Syndrome / Q000150:complications*; D006801:Humans; D008559:Memantine / Q000627:therapeutic use*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors*
D016194:Receptors, N-Methyl-D-Aspartate; D008559:Memantine