Memantine therapy of behavioral symptoms in community-dwelling patients with moderate to severe Alzheimer's disease.
Memantine is a moderate-affinity, uncompetitive antagonist of N-methyl-D-aspartate receptors, approved for the treatment of moderate to severe Alzheimer's disease (AD). Available data suggest that, in addition to its benefits on cognition, function, and global status, memantine treatment may also help alleviate behavioral symptoms. This article provides an overview of the prevalence, assessment, and treatment of behavioral disturbances in AD, and summarizes current knowledge regarding the effects of memantine on the behavior of community-dwelling patients. We searched EMBASE and PubMed (January 1992 to October 2008) for reports on memantine trials that involved outpatients with moderate to severe AD. All previously unpublished data were obtained from Forest Laboratories, Inc. Behavioral outcomes were assessed in three completed, double-blind, placebo-controlled trials.Overall, patients who received memantine performed better on behavioral measures than those treated with placebo. Post-hoc analyses suggest that memantine treatment was associated with a reduced severity or emergence of specific symptoms, particularly agitation and aggression. Prospective, well-designed trials are warranted to evaluate the efficacy of memantine in patients with significant behavioral symptoms.
Grossberg
George T
GT
Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St. Louis, MO 63104, USA. grossbgt@slu.edu
Pejović
Vojislav
V
Miller
Michael L
ML
Graham
Stephen M
SM
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology*; D001519:Behavior / Q000187:drug effects; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000009:adverse effects / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D018691:Excitatory Amino Acid Antagonists; D008559:Memantine