title: Memantine in everyday clinical practice: a comparison of studies in Germany and Greece.
abstract: OBJECTIVE
  Results from German and Greek non-interventional studies were compared to investigate possible differences concerning efficacy, tolerability and compliance between both countries.
  
  
  METHODS
  In two open-label, multicentre, non-interventional studies, 4,305 patients with mild to severe Alzheimer's disease (AD) were treated with daily doses of 20 mg memantine for 6 months. Efficacy was assessed using the Mini-Mental State Examination (MMSE) and instrumental activities of daily living (IADL) scales. Safety and tolerability were recorded.
  
  
  RESULTS
  After 6 months, the patients showed an improvement of their cognitive performance by 2 MMSE points compared to baseline (p < 0.001). MMSE values were improved in 67.4% of the patients, while 15.1% remained stable, and MMSE deteriorated in 17.5% only. The ability to perform IADL increased, as is indicated by lower values (baseline: 70.5; after 6 months: 66.6 points). Improvement of cognition and IADL was nearly identical in both countries. Treatment discontinuation was significantly more frequent in the Greek population, mainly due to non-adherence (9.4% of the safety population). 345 adverse events were recorded in 245 patients (6.3%), and they were significantly associated with country and age.
  
  
  CONCLUSIONS
  The results correspond to those of clinical trials and support the efficacy and good tolerability of memantine in a realistic setting. Differences between the countries were observed regarding the baseline characteristics of patients (more female, older and more severe patients in Germany as well as less pretreatment with cholinesterase inhibitors) and regarding premature discontinuation and reported adverse drug reactions, which were both higher in Greece.
authors.affiliation: Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Greece. hans.foerstl @ lrz.tum.de
authors.forename: H
authors.initials: H
authors.lastname: Förstl
authors.forename: S S
authors.initials: SS
authors.lastname: Stamouli
authors.forename: W
authors.initials: W
authors.lastname: Janetzky
authors.forename: A
authors.initials: A
authors.lastname: Galanopoulos
authors.forename: C
authors.initials: C
authors.lastname: Karageorgiou
authors.forename: M
authors.initials: M
authors.lastname: Tzanakaki
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D005260:Female; D005858:Germany; D006115:Greece; D006801:Humans; D008297:Male; D008559:Memantine / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009483:Neuropsychological Tests; D061214:Patient Safety; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D008559:Memantine