Memantine for the treatment of dementia.

BACKGROUND: The use of cholinesterase inhibitors to correct the cholinergic deficit in patients with mild to moderate Alzheimer's disease (AD) is well established. However, the treatment is only effective in about half of the patients for whom it is prescribed. Vascular dementia may respond, at...

Full description

Bibliographic Details
Main Author: Wilcock, G
Format: Journal article
Language:English
Published: 2003
_version_ 1797096748010700800
author Wilcock, G
author_facet Wilcock, G
author_sort Wilcock, G
collection OXFORD
description BACKGROUND: The use of cholinesterase inhibitors to correct the cholinergic deficit in patients with mild to moderate Alzheimer's disease (AD) is well established. However, the treatment is only effective in about half of the patients for whom it is prescribed. Vascular dementia may respond, at least to some extent, to these drugs (T Erkinjuntti and colleagues, Lancet 2002; 359: 1283-90). In 2002, the Committee of Proprietary Medicinal Products recommended that memantine-a drug that acts on the glutamatergic system rather than the cholinergic system-be approved by the European Commission for the treatment of moderately severe to severe AD. Clinical trials have shown some effectiveness of memantine in the treatment of vascular dementia, although it has not been approved for use in this disorder. RECENT DEVELOPMENTS: The results of a study of the effects of memantine on moderate to severe AD have recently been published (B Reisberg and colleagues, N Engl J Med 2003; 348: 1333-41). Reisberg and colleagues treated their patients for 28 weeks, assessed several outcome variables, and found that memantine reduced clinical deterioration without significant adverse effects. This study is important as memantine is the only treatment licensed for patients with more advanced AD. WHERE NEXT? Several questions about the use of memantine as a treatment for AD remain to be answered. How beneficial is memantine treatment in routine clinical practice compared with clinical trials? What is the best way to assess treatment effects? How long do the beneficial effects last? Does memantine have neuroprotective, rather than just symptomatic, effects? In addition, we need to know when to switch from cholinesterase inhibitors to memantine or when to co-prescribe memantine with cholinesterase inhibitors. The efficacy of memantine in vascular dementia also requires further investigation.
first_indexed 2024-03-07T04:45:58Z
format Journal article
id oxford-uuid:d345c2c5-20cb-44fd-8cf2-f92b9cea32a9
institution University of Oxford
language English
last_indexed 2024-03-07T04:45:58Z
publishDate 2003
record_format dspace
spelling oxford-uuid:d345c2c5-20cb-44fd-8cf2-f92b9cea32a92022-03-27T08:10:07ZMemantine for the treatment of dementia.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d345c2c5-20cb-44fd-8cf2-f92b9cea32a9EnglishSymplectic Elements at Oxford2003Wilcock, GBACKGROUND: The use of cholinesterase inhibitors to correct the cholinergic deficit in patients with mild to moderate Alzheimer's disease (AD) is well established. However, the treatment is only effective in about half of the patients for whom it is prescribed. Vascular dementia may respond, at least to some extent, to these drugs (T Erkinjuntti and colleagues, Lancet 2002; 359: 1283-90). In 2002, the Committee of Proprietary Medicinal Products recommended that memantine-a drug that acts on the glutamatergic system rather than the cholinergic system-be approved by the European Commission for the treatment of moderately severe to severe AD. Clinical trials have shown some effectiveness of memantine in the treatment of vascular dementia, although it has not been approved for use in this disorder. RECENT DEVELOPMENTS: The results of a study of the effects of memantine on moderate to severe AD have recently been published (B Reisberg and colleagues, N Engl J Med 2003; 348: 1333-41). Reisberg and colleagues treated their patients for 28 weeks, assessed several outcome variables, and found that memantine reduced clinical deterioration without significant adverse effects. This study is important as memantine is the only treatment licensed for patients with more advanced AD. WHERE NEXT? Several questions about the use of memantine as a treatment for AD remain to be answered. How beneficial is memantine treatment in routine clinical practice compared with clinical trials? What is the best way to assess treatment effects? How long do the beneficial effects last? Does memantine have neuroprotective, rather than just symptomatic, effects? In addition, we need to know when to switch from cholinesterase inhibitors to memantine or when to co-prescribe memantine with cholinesterase inhibitors. The efficacy of memantine in vascular dementia also requires further investigation.
spellingShingle Wilcock, G
Memantine for the treatment of dementia.
title Memantine for the treatment of dementia.
title_full Memantine for the treatment of dementia.
title_fullStr Memantine for the treatment of dementia.
title_full_unstemmed Memantine for the treatment of dementia.
title_short Memantine for the treatment of dementia.
title_sort memantine for the treatment of dementia
work_keys_str_mv AT wilcockg memantineforthetreatmentofdementia