title: Efficacy and Tolerability of a Combination Treatment of Memantine and Donepezil for Alzheimer's Disease: A Literature Review Evidence.
abstract: BACKGROUND
  Two types of drugs have been approved for the symptomatic treatment of Alzheimer's disease (AD): the cholinesterase inhibitors (ChEIs) and memantine. There is a growing interest to know whether the combination of these drugs is safe and if it adds any clinical benefit to patients.
  
  
  OBJECTIVE
  To systematically review published medical literature assessing the efficacy and tolerability of a combination treatment of memantine and donepezil in AD patients.
  
  
  METHODS
  We searched PubMed for English and Spanish-language literature, using the terms "Alzheimer's disease," "cholinesterase inhibitors," "donepezil," and "memantine." Our review focused on clinical trials and observational studies.
  
  
  RESULTS
  Eleven publications representing seven unique studies were selected for this review. Three were randomized double-blind, placebo-controlled trials and four were observational studies.
  
  
  CONCLUSIONS
  Available data revealed that the combination of memantine and donepezil slowed down cognitive decline, prolonged functional independence, and improved behavioral symptoms in patients with moderate to severe AD. The long-term use of the dual therapy decreased the risk of nursing home admission. More longitudinal studies are needed to further examine the role of combined therapy in the management of AD patients.
authors.affiliation: Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA ; Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Riverol
authors.affiliation: Unidad de Neurología Cognitiva y Demencia, Servicio de Neurología, Hospital del Salvador. Facultad de Medicina Universidad de Chile, Santiago, Chile ; Servicio de Neurologia, Clínica Alemana, Santiago, Chile.
authors.forename: Andrea
authors.initials: A
authors.lastname: Slachevsky
authors.affiliation: Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA ; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: López
keywords: Alzheimer’s disease; cholinesterase inhibitors; combined therapy; donepezil; memantine