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[P‐194]: Effect of memantine on behavioral outcomes in Alzheimer's disease
Author(s) -
Cummings Jeffrey L.,
Schneider Eugene,
Peskind Elaine R.,
Tariot Pierre N.,
Graham Stephen M.,
Bell Joanne M.
Publication year - 2005
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2005.06.253
Subject(s) - memantine , irritability , placebo , donepezil , medicine , population , psychology , disease , dementia , alternative medicine , menopause , environmental health , pathology
Background: Memantine is a low-moderate affinity, uncompetitive NMDA receptor antagonist approved in the U.S. for moderate to severe Alzheimer’s disease (AD), is available in Europe, and is under consideration by the U.S. FDA for mild AD. This analysis assessed the effect of memantine on behavioral symptoms using data from two 24-week, doubleblind, placebo-controlled trials, one in moderate to severe AD patients on stable donepezil therapy (study MD-02; N 404) and one in mild to moderate AD patients (study MD-10; N 403).Objective(s): To determine the effect of memantine on behavioral outcomes in AD patients across disease severity. Methods/Results: Behavioral symptoms in both trials were assessed using the Neuropsychiatric Inventory (NPI). The statistical analysis (ANCOVA) was based on the ITT population using a Last Observation Carried Forward (LOCF) approach. Baseline characteristics between treatment groups were comparable within each trial. Statistically significant treatment differences in favor of memantine were observed at endpoint as measured by NPI total score (P .002, study MD-02; P .011, study MD-10). In addition, several NPI domains demonstrated statistically significant treatment differences in favor of memantine. For study MD-02, those domains were agitation/aggression, irritability/lability, and appetite/ eating change; in study MD-10, the score for delusions favored memantine, with statistical trends for irritability, aberrant motor behavior, and appetite/ eating change. In patients asymptomatic at baseline, significantly fewer memantine patients exhibited emergence of agitation/aggression, irritability/lability, and nighttime behavioral disturbances at endpoint compared to placebo patients (study MD-02). In study MD-10, significantly fewer memantine patients exhibited emergence of delusions and irritability/lability at endpoint compared to placebo patients. In study MD-02, memantine patients symptomatic at baseline also exhibited significantly less worsening compared to placebo on symptoms of agitation/aggression, apathy, and irritability at endpoint. In study MD-10, significant domains for memantine versus placebo were delusions and apathy. Conclusions: Effective treatment of behavioral symptoms throughout the course of AD is important with respect to both quality of life and the potential for reducing caregiver burden. The results presented here support the use of memantine to reduce behavioral symptoms associated with AD.