Abstract
Introduction: Currently, five pharmacotherapeutic options are available to treat Alzheimer’s disease: memantine; the three cholinesterase inhibitors donepezil, galantamine, and rivastigmine; and combination treatments with memantine and one cholinesterase inhibitor. Selection of the best course of treatment is based upon the evidence gathered by systematic reviews and meta-analyses of randomized controlled trials. Areas covered: This article provides a risk–benefit analysis of these treatments using evidence from meta-analyses on their safety and their efficacy. Expert opinion: Memantine improves cognitive functions and behavioral disturbances more efficiently than the placebo, both as monotherapy and in combination with donepezil. Although memantine monotherapy and combination therapy are associated with a few individual adverse events such as somnolence, it is well-tolerated and its safety (all-cause discontinuation) is comparable or superior to that of the placebo (agitation). Pooled cholinesterase inhibitors are superior to the placebo in the improvement of cognitive functions, but not behavioral disturbances and they are not well-tolerated, as evaluated by the high discontinuation rate. Donepezil (10 mg/day) and oral rivastigmine and galantamine monotherapies carry the risk for some adverse events including gastrointestinal symptoms. Therefore, we consider that combined treatment with memantine and donepezil is the most useful treatment for Alzheimer’s disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1053-1061 |
| Number of pages | 9 |
| Journal | Expert Opinion on Drug Safety |
| Volume | 17 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 03-10-2018 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Pharmacology (medical)
Cite this
}
The efficacy and safety of memantine for the treatment of Alzheimer’s disease. / Matsunaga, Shinji; Kishi, Taro; Nomura, Ikuo; Sakuma, Kenji; Okuya, Makoto; Ikuta, Toshikazu; Iwata, Nakao.
In: Expert Opinion on Drug Safety, Vol. 17, No. 10, 03.10.2018, p. 1053-1061.Research output: Contribution to journal › Article
TY - JOUR
T1 - The efficacy and safety of memantine for the treatment of Alzheimer’s disease
AU - Matsunaga, Shinji
AU - Kishi, Taro
AU - Nomura, Ikuo
AU - Sakuma, Kenji
AU - Okuya, Makoto
AU - Ikuta, Toshikazu
AU - Iwata, Nakao
PY - 2018/10/3
Y1 - 2018/10/3
N2 - Introduction: Currently, five pharmacotherapeutic options are available to treat Alzheimer’s disease: memantine; the three cholinesterase inhibitors donepezil, galantamine, and rivastigmine; and combination treatments with memantine and one cholinesterase inhibitor. Selection of the best course of treatment is based upon the evidence gathered by systematic reviews and meta-analyses of randomized controlled trials. Areas covered: This article provides a risk–benefit analysis of these treatments using evidence from meta-analyses on their safety and their efficacy. Expert opinion: Memantine improves cognitive functions and behavioral disturbances more efficiently than the placebo, both as monotherapy and in combination with donepezil. Although memantine monotherapy and combination therapy are associated with a few individual adverse events such as somnolence, it is well-tolerated and its safety (all-cause discontinuation) is comparable or superior to that of the placebo (agitation). Pooled cholinesterase inhibitors are superior to the placebo in the improvement of cognitive functions, but not behavioral disturbances and they are not well-tolerated, as evaluated by the high discontinuation rate. Donepezil (10 mg/day) and oral rivastigmine and galantamine monotherapies carry the risk for some adverse events including gastrointestinal symptoms. Therefore, we consider that combined treatment with memantine and donepezil is the most useful treatment for Alzheimer’s disease.
AB - Introduction: Currently, five pharmacotherapeutic options are available to treat Alzheimer’s disease: memantine; the three cholinesterase inhibitors donepezil, galantamine, and rivastigmine; and combination treatments with memantine and one cholinesterase inhibitor. Selection of the best course of treatment is based upon the evidence gathered by systematic reviews and meta-analyses of randomized controlled trials. Areas covered: This article provides a risk–benefit analysis of these treatments using evidence from meta-analyses on their safety and their efficacy. Expert opinion: Memantine improves cognitive functions and behavioral disturbances more efficiently than the placebo, both as monotherapy and in combination with donepezil. Although memantine monotherapy and combination therapy are associated with a few individual adverse events such as somnolence, it is well-tolerated and its safety (all-cause discontinuation) is comparable or superior to that of the placebo (agitation). Pooled cholinesterase inhibitors are superior to the placebo in the improvement of cognitive functions, but not behavioral disturbances and they are not well-tolerated, as evaluated by the high discontinuation rate. Donepezil (10 mg/day) and oral rivastigmine and galantamine monotherapies carry the risk for some adverse events including gastrointestinal symptoms. Therefore, we consider that combined treatment with memantine and donepezil is the most useful treatment for Alzheimer’s disease.
UR - http://www.scopus.com/inward/record.url?scp=85053910099&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053910099&partnerID=8YFLogxK
U2 - 10.1080/14740338.2018.1524870
DO - 10.1080/14740338.2018.1524870
M3 - Article
VL - 17
SP - 1053
EP - 1061
JO - Expert Opinion on Drug Safety
JF - Expert Opinion on Drug Safety
SN - 1474-0338
IS - 10
ER -