As we continue our exploration of treatment options possible for Alzheimer's disease, one drug that is sometimes prescribed to people with this condition is known as memantine. Here, we will be reviewing what exactly this drug does and why it is a potential treatment option for a patient suffering from Alzheimer's.
What is memantine?
Memantine is a drug that can be used in the treatment of moderate to severe Alzheimer's Disease. It is considered to be second-line treatment, behind the Acetylcholinesterase inhibitors that we covered in a previous article. This is also a medication that has a role in the treatment of moderate to severe forms of dementia; a condition that often co-exists with Alzheimer's.
Memantine is designed to target the NMDA receptors in the brain that help regulate brain activity. The main chemical involved with these channels is called glutamate. In a healthy person, glutamate will be secreted to help regulate brain activity, and this process is very important for muscle movements and cognition. When the brain begins to deteriorate, as seen in conditions like Alzheimer's, there is an increase in glutamate because the brain is no longer able to regulate the production. When the brain has such a high level of glutamate, it becomes predisposed to irregular muscle contractions that can manifest as shaking or tremors.
This medication is available in two forms; as a tablet and as a liquid gel. In milder forms of Alzheimer's disease, a patient is able to control their muscles enough to chew and swallow by themselves so a tablet will be a fine choice in this case. As the disease becomes more severe, simple tasks like chewing and swallowing become much harder for these patients, so using the liquid preparation with a syringe will allow a care provider to administer the drug into the patient's mouth for them.
The drug will be started at a lower dose to make sure that side effects are not too dramatic for a patient, and then increased to alleviate as many symptoms as possible without suffering from side effects. The side effects to be mindful of would be dizziness, constipation, and bothersome headaches. Although constipation can be part of the normal cascade of symptoms of Alzheimer's, if a patient with the condition experiences dizziness, there is an increased possibility that they may fall and not be able to brace themselves. This can lead to more extended stays in the hospital and difficult rehabilitation, so it is important to stop the medication if these side effects become obvious.
How effective is memantine for Alzheimer's disease?
Now we know a little more about what this medication is capable of, but the true question yet to be answered is if this is a medication that can truly help a patient suffering from Alzheimer's Disease.
What we already know about this medication is that it is considered to be a second-line therapeutic option for patients, so it will typically be given along with an acetylcholinesterase inhibitor so the effects of memantine may be hard to truly assess. Another thing to keep in mind is that this is a medication given to patients with moderate to severe forms of Alzheimer's disease, so their prognosis is already more pessimistic compared to patients with earlier stages of the disease.
One study did attempt to showcase the effectiveness of memantine alone in a population of patients suffering from Alzheimer's disease. In this investigation, 53 smaller investigations were reviewed and a final summary was obtained after reviewing this large amount of data.
In this study, patients with Alzheimer's were monitored for a six-month period of time. Some of the patients in this grouping received memantine, while the other half of the group received a placebo. The candidates in the study were examined to determine their baseline cognitive function, their ability to live independently, and the severity of dementia assessed using the Mental Function Impairment Scale. At the end of the six-month period, the group of patients receiving a placebo scored 30 percent worse on the assessed parameters, on average, compared to only 20 percent in patients who received memantine.
After reading a result like that, you may think that memantine may not be a much better option compared to placebo medication. True, the results did worsen in the group treated with the medication but what is less obvious is how this could actually impact a patient's life.
Regardless of the medication you will use to try to treat Alzheimer's disease, the patient will worsen with time. The degeneration of the brain is irreversible and as a result, the patient will never regain abilities that they may once have had once the brain becomes too damaged. With this in mind, when you re-examine the results of the study, it becomes clearer that patients who took memantine were able to hold onto their abilities to think, concentrate and had less severe dementia compared to the patients who took a placebo over a six-month period of time.
To extrapolate on this data further, that could mean that a patient would be able to have a higher quality of life because they could still live independently for a few extra weeks to months. The differences between the two groups may only be minor, but for the patient suffering from the disease, it is worth a try to see if the medication can benefit them by extending their independence for a little longer.
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