Matthias W. Riepe Georg Adler Bernd Ibach Birgit Weinkauf Ibrahim Gunay Ferenc Tracik
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Objective: At present, inhibition of
cholinesterase is the treatment of choice for subjects
with mild-to-moderate Alzheimer's disease (AD). Memantine, a noncompetitive antagonist at
N-methyl-d-aspartate receptors, is currently used
to treat subjects with moderate-to-severe AD. The goal of this multicenter, open-label pilot
study was to investigate whether combination
therapy with memantine added to rivastigmine is safe
and beneficial in subjects with mild-to-moderate AD.
Method: Patients with a DSM-IV diagnosis
of dementia of the Alzheimer's type (N = 95), who were treated with rivastigmine (6-12 mg/day)
for a maximum duration of 24 weeks prior to baseline, received memantine (5-20 mg/day) in
combination with rivastigmine for 12 weeks. The
primary efficacy variable was the change in the Alzheimer's Disease Assessment
Scale-cognitive subscale (ADAS-cog) total score at the end of
12 weeks compared with baseline. The study was conducted between September 15, 2003, and
May 27, 2004.
Results: There was a statistically
significant difference between baseline and week 12 for
the ADAS-cog total score, showing a positive
effect of combination therapy. Combination therapy
did not evidence any unexpected safety concerns
and was well-tolerated by most patients.
Conclusion: Memantine in combination
with rivastigmine appears to be safe and beneficial
in patients with mild-to-moderate AD. Our results need to be confirmed in a large, long-term,
randomized, double-blind, placebo-controlled clinical trial.
Prim Care Companion J Clin Psychiatry 2006;8(5):258-263
https://doi.org/10.4088/PCC.v08n0501
© Copyright 2006 Physicians Postgraduate Press, Inc.