September 6, 2010 - A recent study provides more evidence that patients with dementia with Lewy bodies (DLB) may obtain some mild benefits from memantine. The findings were published online August 23 in the Lancet Neurology.
This study represents the largest prospective, randomized, placebo-controlled study of memantine for the treatment of DLB and included 199 patients with mild to moderate Lewy body dementias from 30 specialty centers across Europe. Patients included those with dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). Only patients who were not already taking any form of cholinesterase inhibitor, the standard treatment for Lewy body dementias, were included in the study. (Memantine is commonly prescribed in addition to a cholinesterase inhibitor for Alzheimer’s disease.)
At 24 weeks, memantine provided more improvement on the global status of patients with DLB than patients taking placebo, and also showed significantly greater improvement in psychiatric symptoms than the placebo group. The authors stated “Memantine seems to improve global clinical status and behavioural symptoms of patients with mild to moderate DLB, and might be an option for treatment of these patients.”
Interestingly, patients with PDD showed no significant differences in global status or psychiatric symptoms over placebo. "The type and frequency of concomitant drug use, and the range, mix, and severity of symptoms, which varied between the two subpopulations, might partly account for the differential response to memantine in these two groups," Dr. Emre and colleagues note.
A previous large randomized, placebo-controlled study of memantine included DLB and PDD patients who were simultaneously being treated with cholinesterase inhibitors. This study demonstrated memantine had a significant effect on global status in the overall population, and a more prominent effect in the PDD population studied.
Dr. Emre stated in an email to Medscape Medical News, "I think considering all the evidence together (the results of this study and the 2 previous ones) memantine might be considered as a treatment option in appropriate patients with Lewy body–related dementias."