Reviewed by the Help Dementia Editorial Team — our editors review every article for accuracy against guidance from the National Institute on Aging, the Alzheimer’s Association, and peer-reviewed sources.
This guide is part of our pillar: Dementia Medications Compared Donepezil Rivastigmine Memantine.
Related guide: Dementia Medications Compared — our comprehensive resource on this topic.
Memantine (Namenda) is the second pillar of Alzheimer’s drug treatment after the cholinesterase inhibitors. It works by a different mechanism and is usually added rather than substituted.
Understanding memantine namenda helps families ask better questions and make calmer decisions. The detail below covers what doctors usually skip when explaining memantine namenda.
How Memantine Works
It blocks excessive activity at NMDA receptors that, in Alzheimer’s, get overstimulated by glutamate and damage neurons.
When It Is Started
Typically when Alzheimer’s reaches the moderate stage, often with a MoCA below 20 or worsening function despite donepezil.
How It Is Dosed
Started at 5mg daily and slowly titrated to 10mg twice daily over a month, or as the once-daily extended-release version.
Side Effects
Generally well tolerated. Most common are headache, dizziness, and constipation. Confusion can occur initially.
Combined With Donepezil
The combination has the most evidence for modest additional benefit in moderate Alzheimer’s.
Frequently Asked Questions
Is memantine worth taking?
For moderate Alzheimer’s, evidence supports modest benefit in function and behavior.
Can memantine be used in mild Alzheimer’s?
Trials in mild Alzheimer’s have been inconsistent. Most experts wait until moderate stage.
For more, see National Institute on Aging.
