Memantine 

Overview

Memantine, often known as Namenda, is a cognitive-enhancing drug used to treat moderate to severe dementia in Alzheimer’s condition. Because Memantine belongs to a new class of cognitive enhancers, it differs from the others. Several drugs that operate via a completely distinct mechanism than other drugs that improve cognitive function.

Memantine works by preventing glutamate from binding to its receptors. The theory is that glutamate has a significant impact on the brain circuits linked to memory and learning. In conditions of the brain like Overexcitation of neurons brought on by aberrant glutamate levels may be linked to Alzheimer’s disease involves neuronal cell death eventually causing cognitive and memory problems as well as neuronal cell malfunction decline and breakdown of cognitive abilities). By specifically inhibiting a certain kind of glutamate receptor (the Memantine (NMDA receptor) may assist in lowering the harmful, while still permitting regular neurotransmission consequences of excitotoxicity linked to aberrant glutamate transmission. Furthermore, since Memantine functions in contrast to other cognitive enhancers, it may be used with other cognitive-enhancing substances such Aricept. 

In a single, brief clinical trial lasting 24 weeks, participants who took Memantine with Aricept compared to those on Aricept alone, those using the combination performed better on tests of cognition, everyday activities, and general functioning; however, the research did not provide information on the combination’s long-term advantages.

Information about Dosing

Memantine is prescribed at a beginning dose of 5 mg once a day. The dose is raised by 5 mg each day, with at least one week’s gap between each increase. For instance, the dose is raised to 5 mg twice a day after a week (10 mg daily). Based on the patient’s reaction and tolerance to the drug, the dosage is adjusted. It is advised to take 10 mg twice a day (20 mg/day) as the goal dose. Due to a decreased renal excretion of Memantine, patients with renal impairment may need lower doses.

Typical Side Effects

In general, Memantine is widely tolerated. The most commonly reported Memantine adverse effects are dizziness, headache, disorientation, constipation, weariness, drowsiness, and generalized aches and pains throughout the body. These negative consequences were more common with the dose of 20 mg per day; nonetheless, adverse effects are often minor, temporary, and disappear after a week or three of continuous treatment. Memantine may make you drowsy and dizzy, particularly during first commencement of treatment

Adverse Events and Safety Measures

Patients on Memantine had a greater incidence (4%) of elevated blood pressure in clinical studies compared to those on patients (2%), who were given a placebo. The possibility of Memantine causing high blood pressure is unclear. When using Memantine, patients should check their blood pressure often.

The kidneys are the main organs in the body that eliminate Memantine. The kidneys’ expulsion of Memantine is considerably lowered when the urine is basic (alkaline), which might decrease Memantine clearance by about Eighty percent. ailments (such urinary tract infections), drugs (like acetazolamide-containing Diamox), and salt: It would be anticipated that meals high in bicarbonate or urine-alkalizing foods will lessen the body’s excretion of Memantine. It might cause the medicine to accumulate and perhaps intensify the negative effects. 

Memantine has a history of producing vertigo. For elderly who may be more prone to falling, this is especially concerning. Patients and caregivers need to know when treatment is starting and when greater doses are necessary about this possible negative consequence and the chance of falling.

During clinical studies, Memantine was associated with agitation and aggressive behavior. caregivers for individuals with that agitation or aggressive behavior may not always be symptoms of Alzheimer’s disease. symptoms of dementia, but they might also be brought on by a drug side effect. Members of the family should report any appreciable behavioral change reported by the patient to their doctor.

Potential Interactions with Drugs

There aren’t many noteworthy medication interactions linked to Memantine. Since it is not thoroughly metabolized by the liver but are mostly eliminated unaltered via the kidneys, other drugs don’t significantly affect Memantine’s metabolic process. On the other hand, ailments, drugs, or dietary habits that affect the condition of urine, increasing its alkalinity, might impact Memantine excretion. Carbonic anhydrase inhibitor medications, such as (methazolamide) and Diamox, are administered as diuretics and for therapy of glaucoma, may reduce the excretion of Memantine and alkalinize urine. Alka-Seltzer and baking soda both include sodium bicarbonate, which is an alkalinizing agent.

Alcohol consumption should be avoided by Memantine patients since the combination may exacerbate sedation and fatigue. Additionally, alcohol’s sedative properties may have a depressive impact, masking its therapeutic benefits of Memantine and making therapy more difficult.

overindulgence

Few overdoses with Memantine have been reported, and knowledge about overdose care is always changing. An instance of 400 mg (forty 10-mg pills) of Memantine overdose has been documented.
The patient had loss, anxiety, sleeplessness, visual hallucinations, psychosis, and stupor of awareness. After taking too much, the patient recovered.
Treating any suspected overdose as an emergency is imperative. The individual has to be brought to the emergency space for care and observation. It is advisable to bring the prescription bottle of medicine (as well as any additional medication that may have been taken in excess) since the information on the label may be useful in helping the treating physician figure out how many tablets the patient has taken.

Particular Points to Remember

• Take the missed dosage as soon as you remember. Ignore the missed dosage if the next scheduled dose is approaching and go on with your usual dosage regimen. Avoid taking two doses at once. You may take Memantine with or without meals.
• Taking the prescription in the morning and just before bed is the recommended course of action.
• Prolonged diarrhea and vomiting may lead to electrolyte loss and dehydration, which can be hazardous, particularly for elderly people. Notify your doctor if you have chronic diarrhea or vomiting for longer than a day.
• Memantine may make you drowsy and dizzy, particularly when starting treatment, and it may affect your attentiveness. When driving or doing other duties that call for attentiveness, proceed with care.
• Keep the medicine out of direct sunlight and dampness, in the light-resistant container that came with it. Warmth and Moisture may hasten the disintegration of your prescription and cause it to lose its medicinal benefits.
• Make sure kids can’t get to your medicine.