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Too good to be true - memantine and what to do

Weasell

Registered User
Oct 21, 2019
404
Thanks for the replies @Dragonfly1. We've never seen a memory clinic so GP must have prescribed the memantine. He's gone up to the 10 mg dose today, I don't know what to expect. He's been doing OK on the 5 mg dose, anger has subsided and his awareness, eye sight and vocabulary are much improved. He's not sitting with his head hung morosely like he was on Donepezil. The toileting is a bit hit and miss, we had a good routine going and now he doesn't seem so aware of the need to go. But I do wonder why he needs to go up to 20 mg (it goes up weekly) and worried about side effects. Agree with you about skepticism with meds, do they really help or do they actually hinder? I've been researching on the web and read articles which state that the Alzheimer meds offer only a tiny help with the condition.
My area of interest is Memantine for vascular dementia.
I stumbled on a transcript of a meeting of dementia experts, from a country where you pay for your meds ( I can’t remember which one it was !) they were reporting success with vascular dementia. At present it is not prescribed for vascular dementia in the uk. I have had an interest since then.
I have cut and paste this from one article I have read.
It is boring except the conclusion at the bottom.

Results— After 28 weeks, the mean ADAS-cog scores were significantly improved relative to placebo. In the intention-to-treat population, the memantine group mean score had gained an average of 0.4 points, whereas the placebo group mean score had declined by 1.6 points, ie, a difference of 2.0 points (95% confidence interval, 0.49 to 3.60). The response rate for CIBIC-plus, defined as improved or stable, was 60% with memantine compared with 52% with placebo (P=0.227, intention to treat). Among the secondary efficacy parameters, which were analyzed in the per-protocol subset, MMSE was significantly improved with memantine compared with deterioration with placebo (P=0.003). The Gottfries-Brane-Steen Scale intellectual function subscore and the Nurses’ Observation Scale for Geriatric Patients disturbing behavior dimension also showed differences in favor of memantine (P=0.04 and P=0.07, respectively). Memantine was well tolerated with a frequency of adverse events comparable to placebo.

Conclusions— In patients with mild to moderate vascular dementia, memantine 20 mg/d improved cognition consistently across different cognitive scales, with at least no deterioration in global functioning and behavior. It was devoid of concerning side effects.
 

White Rose

Registered User
Nov 4, 2018
679
My area of interest is Memantine for vascular dementia.
I stumbled on a transcript of a meeting of dementia experts, from a country where you pay for your meds ( I can’t remember which one it was !) they were reporting success with vascular dementia. At present it is not prescribed for vascular dementia in the uk. I have had an interest since then.
I have cut and paste this from one article I have read.
It is boring except the conclusion at the bottom.

Results— After 28 weeks, the mean ADAS-cog scores were significantly improved relative to placebo. In the intention-to-treat population, the memantine group mean score had gained an average of 0.4 points, whereas the placebo group mean score had declined by 1.6 points, ie, a difference of 2.0 points (95% confidence interval, 0.49 to 3.60). The response rate for CIBIC-plus, defined as improved or stable, was 60% with memantine compared with 52% with placebo (P=0.227, intention to treat). Among the secondary efficacy parameters, which were analyzed in the per-protocol subset, MMSE was significantly improved with memantine compared with deterioration with placebo (P=0.003). The Gottfries-Brane-Steen Scale intellectual function subscore and the Nurses’ Observation Scale for Geriatric Patients disturbing behavior dimension also showed differences in favor of memantine (P=0.04 and P=0.07, respectively). Memantine was well tolerated with a frequency of adverse events comparable to placebo.

Conclusions— In patients with mild to moderate vascular dementia, memantine 20 mg/d improved cognition consistently across different cognitive scales, with at least no deterioration in global functioning and behavior. It was devoid of concerning side effects.
This is really interesting @Weasell, my partner has vascular dementia mixed with Alzheimer's. I wonder if he's been on the wrong medication all these years (Donepezil). I really am constantly amazed at the difference in him since he switched to Memantine. He's gone up to 10 mg now but even on 5 mg there was a huge difference. Suddenly he was aware of things, noticing, his eyesight is better, his vocabulary is better, he understands a lot of what I say to him now, I'm not constantly repeating myself. Yesterday evening we walked to the park and he was walking normally next to me, not his usual snails pace, he commented on the colour of some flowers, he was enjoying watching the pigeons, noticed the lake between the trees. He can see his glass of water on the table, whereas before I would point it out to him and he wouldn't see it. He does't sit morosely grumbling that he's got nothing and no one cares for him and he's dead! He's been interacting with the carers, has been asking to go out in the car with them. I could go on but honestly my life with him has improved immensely - long may it last!
 

Weasell

Registered User
Oct 21, 2019
404
This is really interesting @Weasell, my partner has vascular dementia mixed with Alzheimer's. I wonder if he's been on the wrong medication all these years (Donepezil). I really am constantly amazed at the difference in him since he switched to Memantine. He's gone up to 10 mg now but even on 5 mg there was a huge difference. Suddenly he was aware of things, noticing, his eyesight is better, his vocabulary is better, he understands a lot of what I say to him now, I'm not constantly repeating myself. Yesterday evening we walked to the park and he was walking normally next to me, not his usual snails pace, he commented on the colour of some flowers, he was enjoying watching the pigeons, noticed the lake between the trees. He can see his glass of water on the table, whereas before I would point it out to him and he wouldn't see it. He does't sit morosely grumbling that he's got nothing and no one cares for him and he's dead! He's been interacting with the carers, has been asking to go out in the car with them. I could go on but honestly my life with him has improved immensely - long may it last!
how lovely to hear that !
I am always so interested when people post about medication successes, or failures.
someone posted they were happy with a Mementine and risperidone mix the other day, That may have been to counter hallucinations though.
Talking point is such an enjoyable way of improving your knowledge on things like medication, because it isn’t dry and boring the information is so much easier to digest!
 

jenniferjean

Registered User
Apr 2, 2016
752
Basingstoke, Hampshire
We've never seen a memory clinic so GP must have prescribed the memantine.
My husband is on both Donepezil and Memantine. He had been on Donepezil for a few years and then I discovered a course of Memantine had be prescribed. I assumed our GP had prescribed it but found out that the GP had contacted the memory clinic and they prescribed it without seeing my husband. I did kick up a fuss about that with the GP who had assumed we had been seen at the clinic. I refused to give my husband the new medication until we were seen at the clinic. As I said, he is now on both. The only difference I have seen is that he isn't staying awake when he wakes at night. Before he used to wake up wanting the toilet but would keeping getting up to go as he was forgetting he'd been. That was exhausting to live with. Now he does still wake and want the toilet but goes and then goes straight back to sleep. I've seen no difference during the day.
 

White Rose

Registered User
Nov 4, 2018
679
My husband is on both Donepezil and Memantine. He had been on Donepezil for a few years and then I discovered a course of Memantine had be prescribed. I assumed our GP had prescribed it but found out that the GP had contacted the memory clinic and they prescribed it without seeing my husband. I did kick up a fuss about that with the GP who had assumed we had been seen at the clinic. I refused to give my husband the new medication until we were seen at the clinic. As I said, he is now on both. The only difference I have seen is that he isn't staying awake when he wakes at night. Before he used to wake up wanting the toilet but would keeping getting up to go as he was forgetting he'd been. That was exhausting to live with. Now he does still wake and want the toilet but goes and then goes straight back to sleep. I've seen no difference during the day.
I wonder if it's because of my partner's vascular dementia (he has Alzheimer's and Vas Dem mixed) that Memantine is helping. It is quite amazing how much difference it's made, mostly improved language skills and reduction in anger. He's been looking at books again and can keep himself occupied with that for an hour or so. Now he's asking for a bicycle though!
 

Weasell

Registered User
Oct 21, 2019
404
I wonder if it's because of my partner's vascular dementia (he has Alzheimer's and Vas Dem mixed) that Memantine is helping. It is quite amazing how much difference it's made, mostly improved language skills and reduction in anger. He's been looking at books again and can keep himself occupied with that for an hour or so. Now he's asking for a bicycle though!
it could be worse! He could be asking for a motorbike!

Just wanted to say thank you for posting this, it is always so lovely to receive good news.

I personally would like to see more posted on medication. Not all medication costs the same and the more knowledgeable we are on medication the more incentive healthcare professionals have to prescribe the ‘ right thing’!

My father suffered from migraine. he kept diary’s of food intake etc and reported back to the Gp on his finding and things like how to cure the echo headaches the Triptan medication caused. The GP found it in his budget to fund acupuncture treatments etc. All is not equal in healthcare I firmly believe the more you know the more you get!
 

White Rose

Registered User
Nov 4, 2018
679
it could be worse! He could be asking for a motorbike!

Just wanted to say thank you for posting this, it is always so lovely to receive good news.

I personally would like to see more posted on medication. Not all medication costs the same and the more knowledgeable we are on medication the more incentive healthcare professionals have to prescribe the ‘ right thing’!

My father suffered from migraine. he kept diary’s of food intake etc and reported back to the Gp on his finding and things like how to cure the echo headaches the Triptan medication caused. The GP found it in his budget to fund acupuncture treatments etc. All is not equal in healthcare I firmly believe the more you know the more you get!
My daughter had headaches, sometimes migraines most of her young life and we discovered that it was most probably the orange and apple juice that she used to drink a lot of, took us a long time to work that out though.
I just spoke to the GP, she said medication is not usually given to those with vascular dementia, so maybe it's just luck that the Memantine seems to be helping my partner. In terms of conversation and comprehension, awareness and interest in things I think he's gone back to how he was a year ago. Other aspects haven't changed, so for example he still can't dress himself or work the shower or light switches, etc., he has no ability to think for himself. He's moved to the 10 mg dose now so I asked why he needs to go up to 20 mg, she said it's normal to be prescribed 20 mg. I'm going to monitor because if the 20 mg doesn't show improvement from the 10 mg then what's the point in taking a larger dose than you need?
 

Weasell

Registered User
Oct 21, 2019
404
My daughter had headaches, sometimes migraines most of her young life and we discovered that it was most probably the orange and apple juice that she used to drink a lot of, took us a long time to work that out though.
I just spoke to the GP, she said medication is not usually given to those with vascular dementia, so maybe it's just luck that the Memantine seems to be helping my partner. In terms of conversation and comprehension, awareness and interest in things I think he's gone back to how he was a year ago. Other aspects haven't changed, so for example he still can't dress himself or work the shower or light switches, etc., he has no ability to think for himself. He's moved to the 10 mg dose now so I asked why he needs to go up to 20 mg, she said it's normal to be prescribed 20 mg. I'm going to monitor because if the 20 mg doesn't show improvement from the 10 mg then what's the point in taking a larger dose than you need?
I agree completely!
By coincidence In the above post I mentioned my father solving the issue of the ‘echo ‘headaches. The ‘cure’ was to cut the tablet in half! Even the lowest dose it could be prescribed in was too much, the half a tablet cured the initial migraine with no trade off!
I think we can all suffer from ‘white coat syndrome’ doing what we are told while ignoring the evidence in front of our eyes sometimes.

Wishing you well.