Memantine Hydrochloride, CAS number 41100-52-1, is an effective oral medication for treating patients with Alzheimer’s disease. Memantine is the first in a new and formidable class of Alzheimer’s drugs which work by blocking NMDA glutamate receptors. Known as it’s brand name Namenda, marketed in the United States by Forest Laboratories, memantine is typically prescribed for the treatment of moderate to severe dementia associated with Alzheimer’s disease.
The usual starting dose of the tablet form memantine is 5 milligrams, taken once a day. Increased dosing often occurs, to a twice a day dose of 5 milligrams, and eventually titrated at 10 milligrams twice daily. In capsule form the initial recommended dose of memantine is 7 milligrams daily. The dose is typically increased an additional 7 milligrams weekly, but the maximum dose is 28 milligrams per day. Memantine capsules can either be swallowed whole or opened and sprinkled on a soft food, such as applesauce. Capsules should not be crushed or chewed. Tablets and capsules may be taken with or without food. Side effects sometimes include fatigue, blood pressure elevation, dizziness, constipation, headache, vomiting, back pain, confusion, hallucinations, and coughing. A serious and rare, but documented, skin reaction called Stevens-Johnson syndrome may occur in patients who are taking memantine.
On March 7, 2012 a study was released and published in the New England Journal of Medicine, which involved 295 Alzheimer’s patients in Britain who were given memantine and donepezil (previous blog post from 3/7/12). These patients were placed in one of four separate groups: patients continuing to take donepezil; patients stopping donepezil and receiving a placebo; patients stopping donepezil and starting memantine; and patients taking both memantine and donepezil together. The value of treating patients with mild to severe Alzheimer’s was found upon studying the effects of both memantine and donezepil. The continuation of drug treatment, even in patients deemed severe, proved to be effectual and successful when compared to the placebo group in this study. Patients who received both memantine and donezepil in this study fared significantly better, displaying worthier cognitive and functional abilities in comparison to the other study participants. The World Health Organization estimates that dementia cases will just about double every two decades, thus rising to about 66 million cases in 2030, and 115 million in 2050. Urgent research and effectual medication options are greatly needed for this future patient population.
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