The question investigated for this literature search was: “do patients with moderate to severe Alzheimer’s disease (AD) show slower cognitive decline when receiving memantine treatment combined with cholinesterase inhibitors (ChEI) such as donepezil, compared to treatment with ChEI monotherapy?” The MeSH program was utilized to identify the proper key search terms. The key search terms use were Alzheimer’s disease, memantine, donepezil, and moderate to severe.
While treating moderate to severe AD with the cholinesterase inhibitor (ChEI) donepezil has been shown to be beneficial in improving cognition and overall functioning of patients, the long-term effects of adding memantine for a combined treatment have not been as well researched and documented. In a longitudinal study conducted by Lopez et al. (2009), a total of 943 patients with probable AD were examined and followed up for at least one year. Of the 943 patients, 140 received a combined treatment of memantine with ChEI, 387 received ChEI monotherapy, and 416 received no treatment. The study found that those patients receiving the combined treatment, had greater health benefits than those on ChEI monotherapy and delayed admission to nursing homes.
In a review of key studies, Patel & Grossberg (2011) found similar results in two of the three studies reviewed. The most compelling evidence they found, came from a 24-week phase III clinical trial showing that adding memantine to established donepezil treatment for moderate to severe AD, significantly improved cognition and overall functioning in the patients receiving the combined treatment compared to those on monotherapy.
In another review of studies, Tampi & van Dyck (2007) also found memantine to be effective in slowing the progression of cognitive decline when given in a combined treatment with...