The efficacy and safety of memantine for the treatment of Alzheimer’s disease

Shinji Matsunaga, Taro Kishi, Ikuo Nomura, Kenji Sakuma, Makoto Okuya, Toshikazu Ikuta, Nakao Iwata

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1053-1061
Number of pages9
JournalExpert Opinion on Drug Safety
Volume17
Issue number10
DOIs
Publication statusPublished - 03-10-2018

Fingerprint

Memantine
Alzheimer Disease
Rivastigmine
Safety
Cholinesterase Inhibitors
Galantamine
Placebos
Cognition
Meta-Analysis
Therapeutics
Expert Testimony
Randomized Controlled Trials
donepezil

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Matsunaga, Shinji ; Kishi, Taro ; Nomura, Ikuo ; Sakuma, Kenji ; Okuya, Makoto ; Ikuta, Toshikazu ; Iwata, Nakao. / The efficacy and safety of memantine for the treatment of Alzheimer’s disease. In: Expert Opinion on Drug Safety. 2018 ; Vol. 17, No. 10. pp. 1053-1061.
@article{0c46a9bf95194558950fe3fa29036699,
title = "The efficacy and safety of memantine for the treatment of Alzheimer’s disease",
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.",
author = "Shinji Matsunaga and Taro Kishi and Ikuo Nomura and Kenji Sakuma and Makoto Okuya and Toshikazu Ikuta and Nakao Iwata",
year = "2018",
month = "10",
day = "3",
doi = "10.1080/14740338.2018.1524870",
language = "English",
volume = "17",
pages = "1053--1061",
journal = "Expert Opinion on Drug Safety",
issn = "1474-0338",
publisher = "Informa Healthcare",
number = "10",

}

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 journalArticle

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 -