Medicine
Memantine
SaveAn uncompetitive NMDA receptor antagonist FDA-approved for moderate-to-severe Alzheimer's disease. Blocks pathological tonic glutamate signaling while preserving physiological phasic activation.
Quick verdict
The only approved non-cholinergic Alzheimer's drug. Modest benefits in moderate-to-severe AD, often combined with donepezil. Unique NMDA mechanism.
Evidence score
A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.
What the research shows
RCTs demonstrate improvement in cognition, global function, behavior, and ADLs in moderate-to-severe AD. Combining with donepezil (Namzaric) provides additive benefit. Mechanism is voltage-dependent NMDA channel blockade that reduces excitotoxic noise without impairing normal synaptic signaling.
Benefits
- FDA-approved for moderate-to-severe Alzheimer's
- Unique NMDA-based mechanism complements cholinesterase inhibitors
- Generally well tolerated relative to cholinergic agents
Dosage notes
Start 5 mg/day, titrate by 5 mg/week to target 10 mg twice daily. Extended-release: 7–28 mg once daily.
Side effects
- Dizziness
- Headache
- Confusion
- Constipation
Who should be cautious
Renal dose adjustment required. Avoid with other NMDA antagonists (dextromethorphan, ketamine). May cause confusion in some patients.
What this page cannot tell you
Effect sizes are modest. Benefit in mild AD is not established.
Leaderboard scores
- Memory45
- Mood30
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