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What is Memantine (Namenda)?

Memantine (Namenda) is a drug approved in October 2003 by the Food and Drug Administration (FDA) for the treatment of moderate to severe Alzheimer’s disease. Memantine was first approved in Germany in 1982 for the treatment of various neurological disorders. Since 2002 it has been approved in the rest of the European Union. It is marketed in the US by Forest Laboratories, Inc. under the trade name Namenda and has been available in pharmacies since January 2004.

Memantine’s action differs from the mechanism of the cholinesterase inhibitors that were previously approved in the US for treatment of Alzheimer’s symptoms. Cholinesterase inhibitors temporarily boost levels of acetylcholine, a messenger chemical that becomes deficient in the Alzheimer’s brain.

Memantine is classified as an uncompetitive low-to-moderate affinity N-methyl-D-aspartate (NMDA) receptor antagonist, the first Alzheimer drug of this type approved in the US. It appears to work by regulating the activity of glutamate, one of the brain’s specialized messenger chemicals involved in information processing, storage and retrieval.

Glutamate plays an essential role in learning and memory by triggering NMDA receptors to allow a controlled amount of calcium to flow into a nerve cell, creating the chemical environment required for information storage. Excess glutamate, on the other hand, over stimulates NMDA receptors to allow too much calcium into nerve cells, leading to disruption and death of cells. Memantine may protect cells against excess glutamate by partially blacking NMDA receptors.

Because of the differing modes of action between memantine and the cholinesterase inhibitors previously approved by the FDA (Aricept, Exelon and Reminyl), studies have been conducted on the use of both types of drugs in the treatment of persons with mild to moderate Alzheimer’s disease. The results have been mixed, with some studies showing benefits from the combination therapy and others showing little or no benefits. Studies are ongoing.

Memantine is supplied as an oral medication in 10 mg. Tablets. Adverse effects occurring more commonly with memantine than with placebo included headache, constipation, confusion and dizziness.

Information from Memantine Fact Sheet, published by Alzheimer’s Association in 2004

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