Alzheimer's Disease Assessment Unit/Laboratory of Neuropsychology, IRCCS C. Mondino National Institute of Neurology Foundation, Via Mondino 2, 27100 Pavia, Italy.
Aging Clin Exp Res. 2012 Apr;24(2):193-6. doi: 10.1007/BF03325164.
Memantine is an uncompetitive N-methyl-D-aspartate receptor antagonist. Clinical and observational studies have demonstrated its efficacy on both cognitive and behavioral symptoms of moderate-to-severe Alzheimer's disease (AD) and described its good safety and tolerability profile. We report here our experience with memantine in patients with AD during a two-year follow-up.
From June 2005 to May 2010, memantine was given to 201 outpatients with moderate-to-severe AD: 93 patients were concomitantly receiving treatment with acetyl cholinesterase inhibitors (AChEIs) (Group 1) and the other 108 were prescribed memantine as monotherapy (Group 2). All patients were administered the following scales: Mini Mental State Examination, Activities of Daily Living, Instrumental Activities of Daily Living, Neuropsychiatric Inventory. We report the results of followup assessments conducted at six months and 1, 2 and 3 years.
Sixteen patients (8%) stopped treatment within the first month because of side-effects. In each group, about 20% of subjects showed no deterioration at six months and 1 year, and this proportion decreased only slightly at 2 years. Higher NPI scores at baseline and psychotropic drug use emerged as factors significantly related to reduced response to treatment (p<0.01).
Results confirmed the short-term effect of memantine, both in monotherapy and in combination with AchEIs in moderate-to-severe AD. This efficacy, albeit slight, was found to persist in the longer term.
美金刚是一种非竞争性 N-甲基-D-天冬氨酸受体拮抗剂。临床和观察性研究表明，其对中重度阿尔茨海默病（AD）的认知和行为症状均有效，并描述了其良好的安全性和耐受性特征。我们在此报告我们在为期两年的随访中使用美金刚治疗 AD 患者的经验。
从 2005 年 6 月至 2010 年 5 月，201 名中重度 AD 门诊患者接受了美金刚治疗：93 名患者同时接受乙酰胆碱酯酶抑制剂（AChEIs）治疗（组 1），108 名患者接受美金刚单药治疗（组 2）。所有患者均接受以下量表评估：简易精神状态检查、日常生活活动、工具性日常生活活动、神经精神问卷。我们报告了在 6 个月、1 年、2 年和 3 年进行的随访评估结果。
16 名患者（8%）因副作用在第一个月内停止治疗。在每个组中，约 20%的患者在 6 个月和 1 年内无病情恶化，而这一比例在 2 年内仅略有下降。较高的基线 NPI 评分和使用精神药物被确定为与治疗反应降低相关的显著因素（p<0.01）。
结果证实了美金刚在中重度 AD 中单药治疗和与 AchEIs 联合治疗的短期疗效。这种疗效虽然轻微，但在长期内仍然存在。
