Memantine In The Treatment Of Patients With Alzheimer’s Disease

Objective: Mematine is the only uncompetitive NMDA-receptor antagonist fortreatment of patients with Alzheimer’s disease at present. It can blocke theNMDA-receptor selectively and regulate and control the level of glutamate. Thereby, itfinally slows down the neurodegenerative process. In October2003, the Food and DrugAdministration approved memantine for the treatment of moderate to severe AD. Clinicaltrial proved that mematine slowed down patients’ deterioration in cognitive ability and activityof daily liv ing. Alzheimer disease (AD) is a neurodegenerative disorder characterized bycognitive decline, cognitive decline, decline in activities of daily living, mental and behav ioraldisorders. So far the etiology is unknown, the pathogenesis is complicated. The research isaimed to observe and evaluate the mematine’s treatment of patients with Alzheimer’sdisease.Methods: There are20patients with Alzheimer’s disease. All the patients werecollected from the First Affiliated Hospital of Dalian Medical University, and meet theAD probably diagnostic criteria which made by the NINCDS-ADRDA. All the patientsare treated with memantine for three months. The self-control method was used in theresearch. The improvement in cognitive ability was assessed at0,1,3months usingmini-mental state examination(MMSE) scale, montreal cognitive assessment (MoCA)and clock drawing test. The datas were analyzed by SPSS20.0statistics package, andprobability value was considered significant when＜0.05. Result: The MMSE scores at one month （15.85±5.08）were obviously higherthan the scores before treatment（14.35±4.48，P=0.034）. The MoCA scores at onemonth （11.45±4.72）were also obviously higher than the scores before treatment.（10.00±4.09，P=0.017）. The clock drawing test has indistinctive difference. At the3months, the MMSE scores （16.55±5.66）were significantly better than the control（14.35±4.48，P=0.015）. The MoCA scores （12.45±5.41）were also extremelyhigher than the prior scores（10.00±4.09，P=0.006，P小于0.01）.There was nodifference between the scores of MMSE, MoCA and clock drawing test at one monthand the scores at three months. The directive force, momentary memory, computingpower and attention subtest scores of MMSE at one month and at three months wereextremely higher than the prior scores. While the delayed memory, language ability,visuospatial ability subtest scores was not significant statistically.Conclusion:1. Memantine (10mg/day) has an effect on patients with Alzheimer’sdisease (AD), and can improve the cognitive functions in patients with mild andmoderate dementia remarkably, especially in directive force, momentary memory,computing power and attention.2. Neuropsychological tests (MMSE, MoCA, clockdrawing test) are indispensable in the diagnosis of Alzheimer’s disease and are vital toassess drug’s efficacy. Especially MMSE and MoCA are more sensitive in assessing theefficacy.3. The use of memantine is safe, reliable and well tolerated. It has less adversereaction and has not obvious liver and kidney damage.