Monotherapy with memantine, a low- to moderate-affinity, uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist,
has been shown to be efficacious and safe in patients with moderate to severe
Alzheimer disease. Tariot and colleagues conducted a placebo-controlled randomized
trial among patients with moderate to severe Alzheimer disease receiving a
stable dose of donepezil to assess the efficacy and safety of combining memantine
with cholinesterase inhibitor treatment. After 24 weeks, cognitive, functional,
and global outcomes were significantly better in the memantine group than
in the placebo group.