Combination treatment with memantine and ChEI suggests a comprehensive effect on patients with Alzheimer's

New data showing that combination therapy with a cholinesterase inhibitor (ChEI) and memantine (Axura, from Germany’s Merz) - a non-competitive NMDA (N-methyl-D-aspartate) receptor antagonist - promises significant advantages in the treatment of Alzheimer’s disease, were presented at a satellite symposium held at the Congress of the European Federation of Neurological Societies (EFNS) in Budapest, Hungary. There are indications that AD patients retain their cognitive skills, basic everyday activities, social behavior, and communication skills for longer.

Chairman David Wilkinson, Director of the Memory Assessment and Research Centre (MARC) Southampton, UK, explained that AD patients become physically and mentally dependent on their caregivers. Therefore, a key objective of current treatments is to slow down progression of the disease which can profoundly improve the quality of life of AD patients and their carers. The combination treatment of ChEl donepezil (Eisai’s Aricept) and memantine is one possibility of maintaining the patient’s condition, he said.

Paul Francis of the Wolfson Centre for Age-Related Disease at King’s College London reported that the NMDA receptor antagonist memantine and the ChEl donepezil have different mechanisms of action. Clinical research with healthy subjects has demonstrated that there is no pharmacokinetic interaction between the two drugs when used in combination. On the contrary, there is preclinical evidence of comprehensive, potentially synergistic effects when the glutamatergic and the cholinergic neurotransmission systems are targeted at the same time. Combined treatment with memantine and donepezil enhanced ACh release to a greater extent than the sum of either drug on its own.