Abstract

Memantine is a non-competitive N-methyl-D-aspartate receptor antagonist. This treatment is indicated in moderately severe to severe (MMSE < 20) forms of Alzheimer's disease (AD). Memantine has limited efficacy. The efficacy of memantine has mainly been studied against placebo in randomised controlled trials (RCT) on 4 clinical evaluation criteria: clinical impression of change, autonomy for activities of daily living, overall cognitive performance, and the presence of psychological and behavioural disorders. Patients with moderate to severe AD taking memantine have shown delays in cognitive decline and loss of functional independence, and appeared generally stable compared to patients taking placebo. The recent literature suggests a positive effect on survival among AD patients treated with memantine. In addition, memantine is a well-tolerated treatment. In the RCT, there was no difference in tolerance between memantine and placebo. Memantine should therefore be considered in the treatment of AD. For various reasons, the progress made with anti-amyloid immunotherapy does not change this approach.

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