Memantine Treatment

[dopaminergic]

Dr. Houser,

I'm curious to hear your opinion on Memantine's viability in treating Alzheimers. Based on this study [1], Memantine is no better than a tea polyphenol in reducing brain excitotoxicity. It reduces brain hippocampal glutamate [2], which would retard long term potentiation. It blocks cholinergic receptors [3], which would decrease learning and short term memory. In a comparison of donepezil, rivastigmine, galantamine, or memantine in a diagnostic test of mental functioning, there were significant differences between memantine treatment versus donepezil, rivastigmine, galantamine, but no difference amoung these last three (memantine was much worse) [4]. In fact, the ONLY improvements in cognition that I can see are simply due to its anxiolytic properties.

My question to you is if you also believe memantine prescription for Alzheimers is misplaced based on the literature? Since the theory [5] is that calcium dysregulation might be responsible for increasing or potentiating amyloid generation, wouldn't a less "brain-impairing" drug be more beneficial? L-theanine comes to mind...

Thanks in advance.




[1]http://www.ncbi.nlm.nih.gov/pubmed/18478543?ordinalpos=8&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
[2]http://www.ncbi.nlm.nih.gov/pubmed/18343551?ordinalpos=6&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
[3]http://www.ncbi.nlm.nih.gov/pubmed/18346850?ordinalpos=17&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
[4]http://www.ncbi.nlm.nih.gov/pubmed/18428102?ordinalpos=20&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
[5]http://www.ncbi.nlm.nih.gov/pubmed/18035450?ordinalpos=40&itool=EntrezSystem2.PEntrez .Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum