Donepezil Memantine

Combination memantine-donepezil more likely to show a smaller decline or an improvement... 

Farlow MR, Taiiot P, Grossberg GT, Gergel 1, Grahm S, Jin J (2003) Memantine/donepezil dual therapy is superior to placebo/donepezil therapy for treatment of moderate to severe... 

Data from product Information for tacrine, donepezil, rivastigmine, galantamine, and memantine.34-38... 

Data from Product Information tacrine, donepezil, galantamine, memantine, and rivastigmine.34-38... 

In the RCT in which participants received memantine and donepezil in combination, less deterioration in cognitive function was recorded in participants receiving combined treatment compared with donepezil alone, as measured by the SIB (mean change from baseline at end point for memantine plus donepezil and donepezil alone was 0.9 and —2.5, respectively, p < 0.001). Memantine also improves behavioural symptoms. 

Tariot PN, Fallow MR, Grossberg GT, et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil a randomized controlled trial. lAMA 2004 291 317-324. 

Clinicians often use each cholinesterase inhibitor in combination with memantine however, the best evidence to date for such combination treatment is the use of memantine in patients with moderate to severe Alzheimer s disease already taking donepezil (Tariot et al. 2004). 

Memantine was approved by the FDA in October 2003 for the treatment of moderate to severe dementia of the Alzheimer s type. Its efficacy has been shown in placebo-controlled trials when taken as a monotherapy (Reisberg et al. 2003 Winblad and Poritis 1999) or in patients receiving stable donepezil therapy (Tariot et al. 2004). It is currently available in 5- and 10-mg tablets, and doses can be administered with or without meals. 

Wilcock G, Mobius HJ, Stoffler A, et al A double-blind, placebo-controlled multicentre study of memantine in mild to moderate vascular dementia (MMM500). Int Clin Psychopharmacol 17 297-305, 2002 Wilcock G, Howe 1, Coles H, et al A long-term comparison of galantamine and donepezil in the treatment of Alzheimer s disease. Drug Aging 20 777-789, 2003... 

Wilkinson D, Doody R, Helme R, et al Donepezil in vascular dementia a randomized, placebo-controlled study. Neurology 61 479-486, 2003 Winblad B, Poritis N Memantine in severe dementia results of the M-BEST study (benefit and efficacy in severely demented patients during treatment with memantine). Int J Geriatr Psychiatry 14 135-146, 1999 Winblad B, Engedal K, Soininen H, et al A 1-year, randomized, placebo-controlled study of donepezil in patients with mild to moderate AD. Neurology 57 489-495, 2001... 

Persons with cognitive decline may respond to rivastigmine (1.5-6 mg twice daily), memantine (5-10 mg daily), or donepezil (5-10 mg daily) (see Chapter 60) affective disorders to antidepressants or anxiolytic agents (see Chapter 30) excessive daytime sleepiness to modafinil (100-400 mg in the morning) (see Chapter 9), and bladder and bowel disorders to appropriate symptomatic therapy (see Chapter 8). 

Alzheimer s disease) and donepezil (79). These findings support the potential for combining memantine and cholinesterase inhibitors in patients with Alzheimer s disease. 

Periclou AP, Ventura D, Sherman T, Rao N, Abramowitz WT. Lack of pharmacokinetic or pharmacodynamic interaction between memantine and donepezil. Ann Pharmacother 2004 38(9) 1389-94. 

Donepezil 2. Galant-amine 3. Memantine May be t anticholinergic effects Sage possesses some anticholinergic effects, such as that on sweating Be aware... 

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