Memantine - how long to take effect?

Discussion in 'I care for a person with dementia' started by lesley1958, Jan 29, 2016.

  1. lesley1958

    lesley1958 Registered User

    Mar 24, 2015
    107
    Bristol
    Dad is 91 and is in reasonable physical health. He was diagnosed with mixed AZ and VD about 3 years ago. In the last year we have seen a decline, especially in terms of sundowning/evening confusion and agitation which takes the all too familiar forms of "wanting to go home" (they are in their home of 50-odd years) and wanting to see his parents - and not knowing my mum or believing he is married of course.

    Before Christmas (15 December-ish) he was reassessed by the consultant who decided to prescribe memantine to try to help with the evening agitation and give my poor mum (who is just fantastic) an easier time. He was on 5mg initially and has now gone up to 10mg - has been on that higher dose for 2 -3 weeks.

    We have not really seen much of an improvement. So what I wanted to ask this group was - does anyone have a view on whether we should give the 10mg a bit longer, or whether I should contact the his dementia nurse to talk about increasing the dose? We are not expecting miracles, but we had hoped (stupidly) that the memantine might calm him though we had not expected any improvement in the confusion.. As I said to my mum, I don't care who he thinks I am as long as he is happy - or happier - and I know she feels the same.

    I tried not to hope the medication would make any difference because I know that with this disease there is no hope, but I'm afraid I did just the same. John Cleese's words in the fim "Clockwise" seem so very apt: "It's not the despair. I can stand the despair. It's the hope I can't stand".

    Thanks to anyone who has any advice to offer.

    Lesley
     
  2. nitram

    nitram Registered User

    Apr 6, 2011
    19,021
    Male
    North Manchester
    I would contact the prescriber.

    The usual titration is from 5mg to 20mg in three weeks in even steps, 20mg is the maintenance rate. There are titration packs that can be prescribed to avoid having to halve 10mg tablets.
     
  3. CeliaThePoet

    CeliaThePoet Registered User

    Dec 7, 2013
    614
    Buffalo, NY, USA
    Drugs like Namenda and Aricept are prescribed to hopefully help the person from declining further, at least for a little while. As you know, improvement is not usually something they promise or deliver. Whether they can quell agitation, I'm not sure, but again, I don't think that is the intended effect. Do contact the nurse to report what you've seen, but be sure to ask specifically about meds to calm his agitation, as I think other options are more likely to do this.

    Good luck.
     
  4. nitram

    nitram Registered User

    Apr 6, 2011
    19,021
    Male
    North Manchester
    #4 nitram, Jan 29, 2016
    Last edited: Jan 29, 2016
    Memantine, along with Sodium Valproate, successfully calmed my wife down.
     
  5. Aisling

    Aisling Registered User

    Dec 5, 2015
    1,807
    Ireland
    hi Lesley,

    My partner is on memamtine for a few months now. I believe it can take 2 to 4 weeks for meds to start working. I take him to the doctor for regular check up and meds review.
    Medication seems to work for some time but doesn't alleviate the ups and downs of this awful condition. He is on maximum dosage now.

    I simply give doctor feedback on T and then give meds as prescribed. Always hoping that I am doing the best for him.

    He doesn't recognise me sometimes and then other times he is looking for me. Very distressing and confusing.

    If you live near your mum and dad you may be able to give your mum a break sometimes.

    Aisling (Ireland)
     

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