Memantine: a comprehensive review of safety and efficacy

Abstract

Background : Memantine is an uncompetitive antagonist of the N -methyl-Daspartate glutamate receptor. It is now approved only for treatment of moderate-to-severe Alzheimer's disease (AD). However, as a growing body of evidence indicates that disturbed glutamate neurotransmission may be central to the pathophysiology of such conditions as obesity, schizophrenia, depression, substance abuse, pain disorders and glaucoma, clinical trials have explored the role of memantine in these and other disorders. Objective : To provide a comprehensive review of the safety and efficacy of memantine across the range of clinical applications in which it has been studied. Methods : A search was done on Pubmed using keyword 'memantine' to identify clinical trials of memantine. Results/conclusion : At present, clinical trial evidence supports the use of memantine in only moderate-to-severe AD. Preliminary studies suggest benefit in frontotemporal dementia, alcohol dependence, post-traumatic stress disorder, headache and obesity, but rigorous clinical trials are needed to confirm these results. Available data indicate that across a range of clinical applications, memantine is a safe and well-tolerated drug.

How Much Do Physicians in Latin America Know About Behavioral Variant Frontotemporal Dementia?

“…Memantine is usually prescribed for bvFTD patients by half of the physicians surveyed in this study. Some recent preliminary studies have argued for the benefits of this uncompetitive antagonist of the N-methyl-D-aspartate glutamate receptor on the behavioral disturbances of bvFTD patients (Boxer et al 2009;Diehl-Schmid et al 2008;Kavirajan 2009;Swanberg 2007;Vossel and Miller 2008). Nonpharmacological treatment was usually indicated by almost half of the participants in this study, who also very frequently suggested psychotherapy for relatives of bvFTD patients.…”

Design, Synthesis, and Biological Evaluation of Coumarin Derivatives Tethered to an Edrophonium‐like Fragment as Highly Potent and Selective Dual Binding Site Acetylcholinesterase Inhibitors

“…[6] Many alternative therapeutic approaches are currently being addressed: these include immunotherapy, [7] neuronal cell regeneration, [8] blockade of Ab formation and amyloid plaque deposition (with inhibitors of a-and b-secretase, and anti-aggregating and b-sheet-breaking agents), [9] induction of Ab cerebral clearance, [10] and blockade of tau hyperphosphorylation and aggregation (with kinase inhibitors and anti-aggregating agents, respectively). [11] Despite such large-scale investigations, results from recent AD clinical trials with new experimental drugs have been quite discouraging.…”

Frontotemporal Lobar Degeneration

“…However, rivastigmine was able to attenuate behavioral symptoms in an open label study (Moretti, Torre et al 2004). NMDA-receptor antagonist memantine may be promising in the treatment of behavioral disturbances (Swanberg 2007;Diehl-Schmid, Forstl et al 2008;Vossel and Miller 2008;Kavirajan 2009;Chow, Graff-Guerrero et al 2011 ). The serotonergic and dopaminergic neurotransmitter systems seems to be affected in FTLD (Procter, Qurne et al 1999;Yang and Schmitt 2001;Franceschi, Anchisi et al 2005 serotonin-reuptake inhibitors (SSRI) such as paroxetin, fluvoxamine, and trazodone have been shown to be efficious in the treatment of obsessive behaviour, agitation, irritability, and depression (Swartz, Miller et al 1997;Litvan 2001;Perry and Miller 2001;Moretti, Torre et al 2003;Lebert, Stekke et al 2004;Huey, Putnam et al 2006).…”