Dizziness memantine

Low affinity use-dependent NMDA recqrtor antagonists meet the criteria for safe administration into patients. Drugs like amantadine and memantine have modest effects on Parkinson s disease and are used as initial therapy or as adjunct to l-DOPA. Their adverse effects include dizziness, lethargy and sleep disturbance. 

Adverse reactions associated with memantine include constipation, confusion, dizziness, headache, coughing, and hypertension. These adverse effects are similar to those experienced with ChE inhibitors. Extra monitoring should be done if memantine is given concurrently with a ChE inhibitor. 

The side effects of memantine are generally mild and include headache, dizziness, and constipation. Memantine is started at an initial dose of 5 mg each morning and is increased to 5 mg twice daily after 1 week. The maximum dose of memantine is 10 mg taken twice daily. A recent study indicates that memantine works syner-gistically with cholinesterase inhibitors (see Section 10.5.5), and it has quickly become routine clinical practice to coadminister memantine with one of these agents. 

Memantine (Namenda) [Anti Alzheimer Agent/NMDA Receptor Antagonist] Uses Mod/ evere Alzheimer Dz Action N-methyl-D-aspartate recqjtor antagonist Dose Target 20 mg/d, start 5 mg/d, t 5 mg/d to 20 mg/d, wait >1 wk before t dose use doses if >5mg/d Caution [B, /-] Hqjatic/mild-mod renal impair Disp Tabs, sol SE Dizziness Interactions t Effects W amantadine, carbonic anhydrase inhibitors, dextromethorphan, ketamine, Na bicarbonate t effects W/ any drug, herb, food that alkalinizes urine EMS Use NaHCOs w/ caution OD May cause restlessness, hallucinations, drowsiness, and fainting symptomatic and supportive... 

Memantine is the first in a novel class of Alzheimer s disease medications acting a.o. on the NMDA receptor of the glutamatergic system. It also acts as an uncompetitive antagonist at different neuronal nicotinic receptors at potencies possibly similar to the NMDA receptor. Memantine is approved for treatment of moderate to severe Alzheimer s disease and its use is associated with a moderate decrease in clinical deterioration of the disease. Common adverse drug reactions (>1% of patients) include confusion, dizziness, drowsiness, headache, insomnia, agitation, and/or hallucinations. 

An alternative strategy for the treatment of AD is the use of the NMDA glutamate-receptor antagonist memantine (Namenda). Memantine produces a use-dependent blockade of NMDA receptors. In patients with moderate to severe AD, use of memantine is associated with a reduced rate of clinical deterioration. Whether this is due to a true diseasemodifying effect, possibly reduced excitotoxicity, or is a symptomatic effect of the drug is unclear. Adverse effects of memantine usually are mild and reversible, and may include headache or dizziness. 

An in vitro study in rats suggested that memantine does not attenuate the anticholinesterase effects of galantamine at therapeutic concentrations. A study in 15 healthy subjects found that the concurrent use of extended-re-lease galantamine 16 mg daily with memantine 10 mg twice daily for 12 days did not affect the pharmacokinetics of galantamine and generally did not increase the incidence of adverse effects, although dizziness may have been more common. ... 

---