Clinical Efficacy and Treatment Guidelines for Alzheimer's Disease

Efficacy of Memantine

• Memantine improves cognition and global assessment in patients with moderate to severe Alzheimer's disease, though the magnitude of effect may not reach clinical significance in all domains 1, 2
• The American College of Physicians recommends considering memantine for patients with moderate to severe Alzheimer's disease, as it may improve quality of life 1, 2

Treatment Duration and Discontinuation

• Consider discontinuation of memantine if clinically meaningful worsening of dementia occurs over 6 months, no clinical benefit is observed during treatment, or patient progresses to severe or end-stage dementia 3
• When discontinuing memantine, a gradual approach is recommended, reducing dose by 50% every 4 weeks until reaching the initial starting dose 3

Combination Therapy

• Memantine can be used as monotherapy or in combination with cholinesterase inhibitors, and combination therapy with memantine plus a cholinesterase inhibitor has shown superior outcomes compared to cholinesterase inhibitor therapy alone 3