Fox, Christopher, Crugel, Monica, Maidment, Ian D., Auestad, Bjorn Henrik, Coulton, Simon, Treloar, Adrian, Ballard, Clive G., Boustani, Malaz, Katona, Cornelius, Livingston, Gill and others. (2012) Efficacy of Memantine for Agitation in Alzheimer’s Dementia: A Randomised Double-Blind Placebo Controlled Trial. PLoS ONE, 7 (5). ISSN 1932-6203. (doi:10.1371/journal.pone.0035185) (KAR id:29466)
PDF
Publisher pdf
Language: English
This work is licensed under a Creative Commons Attribution 4.0 International License.
|
|
Download this file (PDF/605kB) |
Preview |
Request a format suitable for use with assistive technology e.g. a screenreader | |
Official URL: http://dx.doi.org/10.1371/journal.pone.0035185 |
Abstract
Background
Agitation in Alzheimer’s disease (AD) is common and associated with poor patient life-quality and carer distress. The best evidence-based pharmacological treatments are antipsychotics which have limited benefits with increased morbidity and mortality. There are no memantine trials in clinically significant agitation but post-hoc analyses in other populations found reduced agitation. We tested the primary hypothesis, memantine is superior to placebo for clinically significant agitation, in patients with moderate-to-severe AD.
Methods and Findings
We recruited 153 participants with AD and clinically significant agitation from care-homes or hospitals for a double-blind randomised-controlled trial and 149 people started the trial of memantine versus placebo. The primary outcome was 6 weeks mixed model autoregressive analysis of Cohen-Mansfield Agitation Inventory (CMAI). Secondary outcomes were: 12 weeks CMAI; 6 and 12 weeks Neuropsychiatric symptoms (NPI), Clinical Global Impression Change (CGI-C), Standardised Mini Mental State Examination, Severe Impairment Battery. Using a mixed effects model we found no significant differences in the primary outcome, 6 weeks CMAI, between memantine and placebo (memantine lower ?3.0; ?8.3 to 2.2, p = 0.26); or 12 weeks CMAI; or CGI-C or adverse events at 6 or 12 weeks. NPI mean difference favoured memantine at weeks 6 (?6.9; ?12.2 to ?1.6; p = 0.012) and 12 (?9.6; ?15.0 to ?4.3 p = 0.0005). Memantine was significantly better than placebo for cognition. The main study limitation is that it still remains to be determined whether memantine has a role in milder agitation in AD.
Conclusions
Memantine did not improve significant agitation in people with in moderate-to-severe AD. Future studies are urgently needed to test other pharmacological candidates in this group and memantine for neuropsychiatric symptoms.
Item Type: | Article |
---|---|
DOI/Identification number: | 10.1371/journal.pone.0035185 |
Subjects: |
R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA421 Public health. Hygiene. Preventive Medicine R Medicine > RS Pharmacy and materia medica |
Divisions: | Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies |
Depositing User: | Tony Rees |
Date Deposited: | 15 May 2012 13:04 UTC |
Last Modified: | 16 Nov 2021 10:07 UTC |
Resource URI: | https://kar.kent.ac.uk/id/eprint/29466 (The current URI for this page, for reference purposes) |
- Link to SensusAccess
- Export to:
- RefWorks
- EPrints3 XML
- BibTeX
- CSV
- Depositors only (login required):