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Tuesday, May 10, 2011

Namenda and Aricept

What follows is a little information I found on Namenda(Memantine).
This starter pack increases the dosage over the first month
I started taking it about 2.5 weeks ago using a starter pack I received from my Neurologist. So far I have not had any severe side-effects other than being a little "woozy" at times. From what I can find in the research a combination of Aricept (Donepezil) and Nemanda (Memantine) is more effective than taking either one of them alone. Though some improvement of the symptoms may be expected, the main reason I am taking this combination is to slow the disease progress.

A recent research study was being conducted investigating the effectiveness of the drugs Aricept and Namenda in treating Alzheimer's disease. The study shows that both drugs combine to slow down the degeneration caused by Alzheimer's to its patients. After only a year's treatment, the test subjects indicate a reduction in the progress of the disease with the patients not exhibiting any side-effects from the combination.

The researchers report that the combination of the two drugs is more effective in slowing memory and intellectual function degradation than taking either one of the two drugs or none at all. The study shows how the mix of cholinesterase inhibitors like Aricept, Exelon and/or Razadyne and the drug Namenda (Memantine) taken by patients markedly slows down the rate of memory function decline better than those receiving only a single type of cholinesterase inhibitor or even no drug at all.

In earlier stages of the disease, Alzheimer patients are most commonly treated with a single type of cholinesterase inhibitor. Depending on the diagnosis, it can be either Aricept, Exelon or Razadyne. On the other hand, for advanced stages of the disease are typically treated with the medicine Namenda.

The research was conducted on more than 350 patients in a span of 15 years beginning 1990. The patients were separated into three groups with varying treatments. The first group of more than a hundred patients wasn't treated with any medications while the second group received an FDA approved cholinesterase inhibitor. The last group was treated with the inhibitor augmented with memantine, a drug that aids patients and allows them to think better. Every 2 1 years the patients are given tests that indicate their mental abilities as well as their capability to perform normal daily tasks. Results clearly show a significant decrease in the rate of decline for the third group.

The research was still incomplete. However, since during the time of testing, only cholinesterase inhibitors were the most commonly used and mematine was not tested by itself.

Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial.
Tariot PN, Farlow MR, Grossberg GT, Graham SM, McDonald S, Gergel I; Memantine Study Group.
Source: Department of Psychiatry, University of Rochester Medical Center, Monroe Community Hospital, Rochester, NY 14620, USA. pierre_tariot@urmc.rochester.edu. JAMA. 2004 Jan 21;291(3):317-24.

Memantine is a low- to moderate-affinity, uncompetitive N-methyl-D-aspartate receptor antagonist. Controlled trials have demonstrated the safety and efficacy of memantine monotherapy for patients with moderate to severe Alzheimer disease (AD) but no controlled trials of memantine in patients receiving a cholinesterase inhibitor have been performed.

The change in total mean (SE) scores favored memantine vs placebo treatment for SIB (possible score range, 0-100), 0.9 (0.67) vs -2.5 (0.69), respectively (P<.001); ADCS-ADL19 (possible score range, 0-54), -2.0 (0.50) vs -3.4 (0.51), respectively (P =.03); and the CIBIC-Plus (possible score range, 1-7), 4.41 (0.074) vs 4.66 (0.075), respectively (P =.03). All other secondary measures showed significant benefits of memantine treatment. Treatment discontinuations because of adverse events for memantine vs placebo were 15 (7.4%) vs 25 (12.4%), respectively.

In patients with moderate to severe AD receiving stable doses of donepezil, memantine resulted in significantly better outcomes than placebo on measures of cognition, activities of daily living, global outcome, and behavior and was well tolerated. These results, together with previous studies, suggest that memantine represents a new approach for the treatment of patients with moderate to severe AD.

Treatment Effect Size of Memantine Therapy in Alzheimer Disease and Vascular Dementia

Smith, Matthew BASc*; Wells, Jennie MSc, MD†; Borrie, Michael MB, ChB

The purpose of this paper is to assess the clinical relevance of the significant results reported in clinical trials of memantine therapy for Alzheimer disease (AD) and vascular dementia. We sought to understand what clinically detectable changes would be evident to the patient with dementia, their caregivers, and the treating physician during a trial of memantine therapy. A literature search was performed on MedLine, PsycInfo, and the Cochrane database. The statistically significant findings from the memantine literature were reviewed using treatment effect size as a measure of clinical meaningfulness. There have been 3 phase 2 studies of memantine in dementia, and 6 phase 3 studies published as of August 1, 2005. Of the 6 published phase 3 trials of memantine in dementia; 2 were in mild-moderate vascular dementia, 1 in mild-moderate AD, 2 in moderate-severe AD, and 1 in severe dementia (both AD and vascular dementia). The most convincing evidence of a clinically meaningful treatment effect of memantine therapy is in the moderate-severe AD patient population. Cognition, as measured by the Severe Impairment Battery, had an effect size of 0.32 and 0.49 in the 2 published trials, indicating a small-to-medium effect of the medication. Global, functional, and behavioral scales also showed a small-to-medium response to memantine.

Everything here is my account of what happened to me, or my interpretation of stuff. Every case of FTD is different. Keep in mind as you read this that the person who wrote this has Frontotemporal Degeneration. That would be ME.  Medical Disclaimer.

Questions and Comments are welcome.


  1. Is your own doctor interested in running a "post" test to check how you're doing after taking the two drugs for a while?

    And, did you have to change/drop any of the supplements/foods that have helped you so much in order to take the Namenda? (Sorry for any missspellings.)

  2. Both of my doctors frequently check my progress, and my neurologist wants me to be tested again early next year.

    Namenda has very few drug interactions. I have not had to make any modifications with anything else that I take, though I am careful with the Ibuprofen. MSAIDS and Simvastatin both have to be monitored closely with Nemanda and Aricept. As of right now my liver enzymes were very slightly elevated ...so another set of blood tests in 3 months to make sure it is doing ok with the new medications.

  3. My wife is on Namenda for her FTD and for her chronic pain condition. It was prescribed by her pain specialist. We have had good results from it.

    He also recommended that we try out another medicine that is not available in the US, flupirtine. He's from Poland, and it has been used for 20+ years as an analgesic in Europe. It has been found to be strongly neuroprotective. It's in the process for FDA approval here as a treatment for fibromyalgia.

    We have been using this for almost two years, and it has helped her FTD dramatically. It also helped her fibromyalgia-like pain. I get it from a web site in Germany.

    If you're interested in trying it, let me know and I'll send you the details. (ward.ray@gmail.com)

  4. started taking namenda and exelon 2.5 years ago. this has really helped my and my wifes life. am not fine or cured but life is livable. still think i am just as capable as always. family reminds me i am not.