Memantine Doesn’t Work for all Dementias

Memantine did not help people who had frontotemporal lobar degeneration

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Medications for Alzheimer’s disease are sometimes used to treat other types of dementia, like frontotemporal lobar degeneration (FTLD). But they may not be all that helpful.

People with FTLD who took memantine for 26 weeks did not show any improvement in memory, thinking skills or overall function. While memantine may help people with Alzheimer’s disease, it was not an effective treatment for FTLD dementia.

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The study, led by Adam L Boxer, MD, at the Department of Neurology of the University of California in San Francisco, looked to see if Namenda (memantine) would help people with FTLD.

FTLD is a form of dementia in which memory and thinking are affected. However, FTLD differs from Alzheimer’s in that it causes changes in personality and social functioning at early stages of the disease. In Alzheimer’s disease, personality changes and language difficulties usually occur in later stages of the disease.

Memantine is approved by the US Food and Drug Administration (FDA) for the treatment of Alzheimer’s disease. Because FTLD dementia can be similar to Alzheimer’s disease in some ways, memantine is often used for FTLD.

The researchers enrolled 81 patients with FTLD who were between 40 and 80 years old. They took either 20 mg/day of memantine or a sugar pill for 26 weeks. Only 76 of the patients completed the full 26 weeks of the study.

The researchers looked for changes in scores on cognitive tests that measured memory and thinking skills. They also looked for a rating of global clinical improvement by doctor, which means that the person showed improvement in overall function.

Memantine did not improve cognitive test scores or overall function in these patients after 26 weeks of treatment.

People taking memantine reported more cognitive problems during the study, like confusion and memory loss, than those taking sugar pill.

People taking memantine actually performed worse on some of the naming and processing speed aspects of the cognitive tests.

The authors noted that study was small. They planned to have more people, but many of the people who were asked to join the study wanted to just take the drug off-label instead of being in the study.

Published alongside this study, John R. Hodges, an FTLD researcher at Neuroscience Research Australia and University of New South Wales, commented on these findings. He discussed a similar study in France that also found that memantine was not helpful for people with FTLD.

In his commentary, he said, “These study findings are obviously disappointing, especially in view of the consistently positive benefits shown in moderate-to-severe Alzheimer’s disease and other dementia syndromes.

“The message from these papers is clear: memantine should not be prescribed to patients with frontotemporal dementia, and treatment might, in fact, hasten cognitive decline. Although, the evidence for this decline is rather mixed.”

This study was published in the February issue of The Lancet Neurology. The study was funded by the Forest Research Institute, which is a part of the pharmaceutical company Forest Laboratories that makes Namenda.

The authors report affiliations with multiple pharmaceutical and biotechnology companies.

Reviewed by: 
Review Date: 
January 25, 2013
Last Updated:
January 30, 2013