Memantine for Agitation/Aggression and Psychosis in Moderately Severe to Severe Alzheimer's Disease

Wilcock, Gordon; Ballard, Clive; Cooper, James A.; Loft, Henrik

doi:10.4088/jcp.v69n0302

Cited by 235 publications

(130 citation statements)

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“…A recent cohort study reported the risk of elderly patients with dementia developing a short-term serious adverse event to be increased more than three-fold in those receiving either typical or atypical antipsychotics (Rochon et al, 2008). It is therefore relevant to note that while donepezil and rivastigmine capsules may induce agitation as a common AE, potentially augmenting any symptomatic occurrence, the incidence of agitation with memantine is actually reduced; furthermore, post hoc analyses have shown that it may actually prevent the emergence of agitation (Gauthier et al, 2008;Wilcock et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Although this effect size is small and should be treated cautiously (McShane et al, 2006), it is potentially important since agitation is commonly found in late dementia, is an indicator of decline, and is not easily treated. These safety data triggered further efficacy analyses, with the findings suggesting that memantine may reduce symptoms of agitation/aggression in patients with moderate to severe AD and, in asymptomatic AD patients, may prevent the emergence of agitation/ aggression (Gauthier et al, 2008;Wilcock et al, 2008).…”

Section: Agitationmentioning

confidence: 99%

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A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

Jones¹

2010

Int J Geriat Psychiatry

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Objective: Alzheimer's disease (AD) is prevalent among elderly people, who often have comorbid conditions, and may be prescribed multiple medications. Drug safety and tolerability is paramount in maximising efficacy and optimising patient and carer quality of life, as patients are vulnerable to adverse events (AEs) and/or compliance difficulties. The two principal categories of drug used in the treatment of AD are the acetylcholinesterase inhibitors (AChEIs) and the NMDA-receptor antagonist, memantine. This paper reviews the most recent safety data for memantine in comparison with the AChEIs. Design: Review of most recent safety/tolerability data for memantine and AChEIs, derived from metaanalyses, pooled analyses, European SPCs and EMEA publications. Results: Memantine was found to have a favourable tolerability profile when used as monotherapy or in combination with other agents. AChEIs were found to be fairly well tolerated. All treatments commonly or very commonly produce dizziness and/or headache. AChEIs are associated with many more types of AEs than memantine, particularly in the gastrointestinal category. Agitation is a less common AE when comparing memantine treatment to placebo, but just as common when comparing AChEI treatment to placebo. Withdrawals in memantine-treated groups are comparable to placebo, and more common in AChEI-treated groups compared to placebo. Overall, drug-drug interactions, contraindications and warnings were fewer for memantine than AChEIs. Conclusions: In both the clinical and naturalistic setting, memantine displays a safety and tolerability profile that is favourable and distinct from that of AChEIs. Safety and tolerability profiles should be given careful consideration when selecting treatment for AD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Agitationmentioning

confidence: 99%

A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

Jones¹

2010

Int J Geriat Psychiatry

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“…There is large consensus reporting that memantine is highly effective, compared to placebo, in treating and preventing behavioral symptoms of agitation, aggression, delusions and irritability in moderate to severe Alzheimer's Disease [111][112][113] . Larsson et al [114] reported that patients with dementia treated with memantine were less physically active during sleep than patients treated with placebo.…”

Section: Memantine In Treatment-resistant Bipolar Disorder: Clinicalmentioning

confidence: 99%

Memantine: New prospective in bipolar disorder treatment

Serra

Demontis

Serra

et al. 2014

WJP

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“…In the U.S. and Europe, where it has been used for more than ten years, multicenter trials have been conducted reporting that memantine is effective against BPSD [1,2]. On the other hand, the results of a six-study meta-analysis on the usefulness of memantine against moderate to severe AD demonstrated that memantine exhibits ameliorative effects not only on BPSD, but also on cognitive function and general clinical symptoms [3].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Difference of Memantine and Donepezil - Relating to Changes in Cerebral Blood Flow and Clinical Efficacy

Kanaya¹,

Hanyu²

2017

Br J Res

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The effects of memantine on AD were examined from the perspective of cerebral blood flow using SPECT. Significant increases in blood flow were observed bilaterally from the orbital gyrus to the anterior cingulate gyrus, in the hippocampus and Para hippocampal gyrus, and from the posterior cingulate gyrus to the precuneus following single administration of memantine at 20 mg/day in comparison with prior to administration. In concomitant administration with donepezil, significant increases in blood flow were observed over a wide range from the orbital gyrus to the anterior cingulate gyrus and from the right angular gyrus to the superior, middle and inferior temporal gyrus in comparison with prior to additional administration of memantine. A correlation was suggested between these results and improvement of clinical BPSD symptoms such as increased conversation, improvement of irritation and agitation, and elimination of wandering.

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Memantine for Agitation/Aggression and Psychosis in Moderately Severe to Severe Alzheimer's Disease

Cited by 235 publications

References 0 publications

A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

Memantine: New prospective in bipolar disorder treatment

The Effectiveness and Difference of Memantine and Donepezil - Relating to Changes in Cerebral Blood Flow and Clinical Efficacy

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