Using Namenda
The recent approval of Namenda (memantine) for use in moderate or severe Alzheimer disease has raised some questions about the use of this new medication with other previous AD drugs.
The studies documenting some efficacy for Namenda were performed in patients also taking Aricept (donepezil), which is in the class of acetylcholinesterase inhibitors (AChE-I).
Current practice guidelines for pharmacological treatment of AD call for use or attempted use of AChE-I's and high dose vitamin E.
Current Practices
Our current practice pattern at the Bryan ADRC Memory Disorders Clinic is to consider the addition of Namenda in patients with moderate or severe AD.
We would add Namenda to the AChe-I drug (Aricept, Reminyl or Exelon) that they were currently taking. This mimics most closely the actual study design approved by the FDA.
We have some concern and caution about using Namenda in patients who are agitated or hypervigilant.
In addition, if the patient is not taking AChE-I medications, we would probably start or restart AChE-I's before adding Namenda.
