Effectiveness and safety of memantine treatment for Alzheimer's disease

Abstract

Background/objective: Memantine is approved as a treatment for moderate to severe Alzheimer's disease (AD). However, recent studies report that memantine is harmful for AD patients in several ways. This paper will systematically review all the available studies to provide an update regarding memantine as a treatment for AD.

Method: Two authors queried nine databases containing literature published prior to September 15, 2012 and determined eligible studies based on the inclusion criteria. We used Review Manager to pool similar data. The Cochrane Handbook was used to assess the bias of the included studies. The chi-squared test, sensitivity analysis, Egger's test, and funnel plots were used to determine the heterogeneity and report bias, respectively.

Result: We obtained 889 studies and determined that 12 of those studies met the inclusion criteria. The pooled analysis showed that memantine had significant benefits for AD patients in terms of cognition and the clinician's global impression. There were no significant benefits for AD patients in terms of mental state or activities of daily life. The results on brain volume and metabolism were controversial in two of the studies. Memantine did not significantly affect discontinuation caused by serious adverse events but did increase the risk for somnolence, weight gain, confusion, hypertension, nervous system disorders, and falling.

Conclusion: Memantine is beneficial for AD patients with regards to cognition and clinician's global impression but increases the risk for somnolence, weight gain, confusion, hypertension, nervous system disorders, and falling.