What is the purpose of memantine in middle to late stage alzheimer's?

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.).