The European Union's Committee of Proprietary Medicinal Products (CPMP) has recently recommended that the EU approve memantine for the treatment of moderately severe to severe Alzheimer's disease. Memantine is believed to be effective in protecting the cholinergic neurons that are destroyed in Alzheimer's disease.

Memantine is a derivative of the familiar anti influenza drug amantadine. It is currently available only in Germany, where it is used to treat Parkinson's disease and to speed the recovery of comatose patients, as well as to treat dementia. The use of memantine for Alzheimer's is based on the theory that excessive activation of N methyl D aspartate (NMDA) receptors may underlie the degeneration of cholinergic cells, leading to cognitive, social, and motor deficits. Memantine, a fast, voltage-dependent NMDA receptor antagonist, blocks the NMDA receptor in the presence of sustained release of low glutamate concentrations and thus attenuates NMDA receptor function.

A .pdf version of the CPMP opinion can be downloaded from the European Agency for the Evaluation of Medicinal Products.—Hakon Heimer

Comments

  1. The Alzheimer's Society in the UK welcomes all new advances in the treatment
    of Alzheimer's disease. Memantine is a drug that has been used for many years
    in Germany, and will now shortly have a Europe-wide license. Memantine works
    by blocking the glutamate NMDA receptor, preventing or reducing the excitotoxic
    effects of excess glutamate being released by dead and dying nerve cells.

    In the UK, memantine is scheduled to be reviewed by the governments National
    Institute for Clinical Excellence (NICE) in 2003. NICE will make the ultimate
    decision on purchasing it for the National Health Service. Until NICE issues
    guidance, it will be up to individual health authorities to decide whether or
    not to purchase memantine for their patients. The major question about memantine
    will be around its cost-effectiveness—if it can demonstrate the ability to keep
    people out of residential care then it has the potential to be cost-effective.
    However, if it then prolongs the time in residential or nursing home care, it
    is very doubtful whether it could ever be a cost- effective option.

    We also hope to see efficacy data for memantine in milder dementia.

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References

Other Citations

  1. memantine

External Citations

  1. .pdf version of the CPMP opinion

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