Abstract
Memantine is a moderate-affinity glutamate antagonist that primarily takes action at the N-methyl-D-aspartate receptor site. It has US FDA and European Medicines Agency approval for the treatment of moderate-to-severe Alzheimer‘s disease. Memantine replaces Mg2+ at the N-methyl-D-aspartate receptor, blocking pathological glutamate activity but allowing normal glutamate action at this site. Consequently, calcium homeostasis is better maintained, reducing slow after hyperpolarization and preventing neuronal excitotoxicity and cell death. Clinical trials have shown that memantine is generally safe and well tolerated, and have provided evidence for its efficacy as assessed by cognitive, behavioral, functional and global measures. It has also been shown to be well tolerated and effective in the treatment of moderate-to-severe Alzheimer‘s disease when patients received previous and ongoing treatment with donepezil. The tolerability and efficacy of memantine is under continued investigation in milder Alzheimer‘s disease and other forms of dementia.