Psychiatria pre prax 3/2004

Memantine – a noncholinergic alternative of treatment for Alzheimer’s and vascular dementia

Excessive release of glutamate in Alzheimer’s and vascular dementia leads to excitotoxic damage to CNS neurons. Memantine acts as a glutamate NMDA receptor antagonist and blocks glutamate and ?-amyloid neurotoxicity and synthesis of ?-amyloid and ? proteins. Clinical tests have shown memantine as effective in treatment of Alzheimer’s and vascular dementia and as slowing their progression. It adjusted cognitive functions, vigility, and daily activities of patients, and reduced the need for the help of caregivers by increasing patient autonomy. Memantine was tolerated very well and the most frequent side effects included insomnia, dizziness, headache, and hallucinations in less than 5% of patients. Memantine has been shown to be an effective cognitive enhancer to treat even severe forms of Alzheimer’s dementia and mild to medium severe vascular dementias with minor cerebral blood vessels defects.

Keywords: memantine, NMDA antagonists, Alzheimer’s dementia, vascular dementia.