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Memantine is used in moderate to severe Alzheimer’s disease to help slow functional decline and reduce some symptoms. Key points: - Mechanism: It’s an NMDA receptor antagonist that dampens glutamate-related excitotoxicity, which can occur as Alzheimer's progresses. - Purpose in middle to late stages: to slow progression of symptoms, and to help with cognition, daily functioning, and certain behavioral symptoms (e.g., agitation) when added to a cholinesterase inhibitor (like donepezil). It can also be given on its own if a cholinesterase inhibitor isn’t suitable. - What you might expect: modest improvements or stabilization in cognition and daily activities; it’s not a cure and effects can be gradual or variable. - How it’s used: typically started at a low dose and titrated to 10 mg twice daily (for the standard oral form). There is also a combination product with donepezil (Namzaric) for convenience. - Safety: common side effects include dizziness, headache, confusion, and constipation. Kidney function matters because memantine is cleared renally; dosing may be adjusted in kidney impairment. Discuss potential interactions with your clinician. If you’d like, I can tailor this to a specific patient’s situation (other meds, kidney function, same-stage symptoms, etc.).
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