Psychiatria pre prax 4/2010

A surprising effect of memantine on the progression of Alzheimer‘s disease

A case report supplemented by brain CT findings and post-mortem histological examination illustrates the effect of memantine in a previously professionally successful physician during the course of his disease from 81 to 85 years of age when cared for in a home setting. During six weeks of medication, with a baseline MMSE score of 16, the patient regained cognitive and executive functions of almost premorbid level of social adaptability. In oscillations and supported by the use of donepezil, they were maintained for another nine months. Current standards for treatment of dementia favour the commencement of cholinesterase inhibitors in the first line. According to the author's six-year experience with a group of 15 patients diagnosed with G 30.1 and F 01.3, the use of memantine appeared substantially more effective than administration of cholinesterase inhibitors. Treatment with memantine exhibits a negligible risk of adverse side effects. This raises the question of usefulness of establishing the treatment with memantine as the first-choice drug therapy.

Keywords: memantine, donepezil, tiapride, Alzheimer‘s disease, social stimulation, CT image, histological finding, AD symptomatology scale.