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A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors
Author(s) -
Jones R. W.
Publication year - 2010
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2384
Subject(s) - tolerability , memantine , adverse effect , medicine , placebo , pharmacology , psychology , disease , dementia , pathology , alternative medicine
Objective Alzheimer's disease (AD) is prevalent among elderly people, who often have comorbid conditions, and may be prescribed multiple medications. Drug safety and tolerability is paramount in maximising efficacy and optimising patient and carer quality of life, as patients are vulnerable to adverse events (AEs) and/or compliance difficulties. The two principal categories of drug used in the treatment of AD are the acetylcholinesterase inhibitors (AChEIs) and the NMDA‐receptor antagonist, memantine. This paper reviews the most recent safety data for memantine in comparison with the AChEIs. Design Review of most recent safety/tolerability data for memantine and AChEIs, derived from meta‐analyses, pooled analyses, European SPCs and EMEA publications. Results Memantine was found to have a favourable tolerability profile when used as monotherapy or in combination with other agents. AChEIs were found to be fairly well tolerated. All treatments commonly or very commonly produce dizziness and/or headache. AChEIs are associated with many more types of AEs than memantine, particularly in the gastrointestinal category. Agitation is a less common AE when comparing memantine treatment to placebo, but just as common when comparing AChEI treatment to placebo. Withdrawals in memantine‐treated groups are comparable to placebo, and more common in AChEI‐treated groups compared to placebo. Overall, drug–drug interactions, contraindications and warnings were fewer for memantine than AChEIs. Conclusions In both the clinical and naturalistic setting, memantine displays a safety and tolerability profile that is favourable and distinct from that of AChEIs. Safety and tolerability profiles should be given careful consideration when selecting treatment for AD patients. Copyright © 2009 John Wiley & Sons, Ltd.