DIMENSIONS Summer 2003

QUESTIONS AND ANSWERS

by Joanne Webb

Q. Is there anything new in drug therapy for Alzheimer's patients?

A. The latest drug in the news for Alzheimer's disease is called Memantine. Memantine has not been approved by the FDA, and thus is not available to the American public. Approved in Germany for over 10 years, Memantine is undergoing drug trials here in the United States both as a "stand alone" treatment option and in concert with the three Alzheimer's disease medications that are approved and marketed in the U.S. (Aricept, Reminyl, and Exelon). The studies are treating patient groups at different stages of Alzheimer's disease, ranging from mild to severe. So far the effect of Memantine in the placebo controlled trials is pretty much the same as the three approved "anti-dementia" drugs. It slows down the progression but does not alter the actual disease process.

Memantine affects the brain differently than the other Alzheimer's disease drugs. Memantine influences the glutamate neurotransmitter system, whereas all three of the other drugs affect the acetylcholine system. Because of this, the side-effect profile of Memantine is different, and it can potentially be recommended to patients who cannot tolerate Aricept, Reminyl and Exelon. In addition, using it along with one of the other drugs may provide greater benefits than either drug alone. Initial data from a combination therapy research trial using Aricept and Memantine suggest that individuals using the two drugs together fare better in terms of their thinking skills and ability to perform daily tasks than those who took Aricept and a placebo, but the combination therapy trial has yet to undergo peer review or be published and, as such, is incomplete at this time.

For more information on Memantine, refer to the Alzheimer's Association webpage, at www.alz.org, where you can view a "Fact Sheet" about it.


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