Memantine headache

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 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. 

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