Re: Memory: Does Namenda Work? Dr. Rabins Addresses a Difficult Question

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_Does Namenda Work? Dr. Rabins Addresses a Difficult Question_

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In this excerpt from a recent issue of the Memory Disorders Bulletin,

medical editor Dr. V. Rabins confronts the difficult question: What do

you do when a caregiver asks, " Dr. Rabins, do you think that Namenda

is really working? "

Namenda (memantine) was widely available for about 20 years in Europe

before it received approval in 2003 for Alzheimer's disease therapy from the

Food and Drug Administration (FDA). Namenda is approved for people with

moderate and severe Alzheimer’s disease, but some doctors, including memory

and

dementia experts, offer it to all of their patients with Alzheimer's,

regardless of the severity of their symptoms.

Many doctors who are specialists in Parkinson's disease and frontotemporal

dementia are using Namenda for their patients with dementia symptoms, even

though it is not FDA-approved for that. While it is perfectly within their

purview to use a medication " off label " for Alzheimer’s disease if they

feel it's warranted, I hope studies will be carried out to tell us whether

Namenda does have positive benefits.

There is no cure for Alzheimer’s disease, so the goal of drug therapy for

Alzheimer’s disease is to help manage the symptoms. Improvement in cognition

is an indicator that Namenda might be working. Therefore, when a caregiver

asks me if I think that Namenda is working for their loved one, I answer

" yes " only when I can see an improvement on a scale that measures cognition

or thinking.

Should you choose Namenda? The decision to use Namenda depends more on the

preferences of the Alzheimer’s disease patient and his or her family than

on the science. Many families and caregivers say, " If Namenda might help,

even a little bit, I want my loved one to take it. "

On the other hand, some families and patients say, " I don't want to take

something that will only make a small difference. " For these individuals, I

work to get them as much information about Alzheimer’s disease as possible

to help manage any behavioral or psychiatric symptoms and to address the

financial, legal, ethical and social problems they are facing.

There is no " right " or " wrong " when it comes to this issue. It is the

patient and family who should make the final decision, not the doctor. I feel

the same way about stopping Namenda. It is up to the patient and family to

decide once they are given the information in a balanced and fair manner.

However, colleagues whose opinions I value feel that a drug such as Namenda

offers false hope and the benefit is so minimal that it should not be used

unless family members feel strongly that they want to try it with their

loved one.