INTRODUCTION: The aim of this systematic review is to evaluate efficacy, safety and tolerability of memantine, a non-competitive agonist of N-methyl-D-aspartate (NMDA) receptor, on the treatment of moderate to severe Alzheimer disease. METHODS: A search in MEDLINE database was made using key words memantine and Alzheimer's disease. Only randomized, double-blinded and placebo controlled clinical trials were included. RESULTS: Four studies were found that fulfilled inclusion criteria; all patients had moderate or severe Alzheimer disease. All studies suggested that memantine is superior to placebo for the following parameters: improvement in functional abilities and more participation in daily activities. Two studies suggestted cognitive improvement. Mean duration of studies was 28 weeks, and doses of memantine ranged between 10 to 20mg/bid. Side effects, in all studies, were worst for placebo group. DISCUSSION: In spite of its costs, memantine seems to reduce total costs and time spent by caregiver, and improves patient and caregiver quality of life.
memantine; Alzheimer; treatment
