Memary ,meantine-related case reports

Inappropriate Drugs in Elderly Patients with Severe Cognitive Impairment: Results from the Shelter Study

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463565/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463565/pdf/pone.0046669.pdf


 Lipid-lowering drugs and antiplatelet agents (but not ASA)

followed by

anti-dementia drugs (acetylcholinesterase inhibitors and

memantine ) were the most frequently

inappropriate drugs used,....



Treatments for Depression in Older Persons with Dementia

PMCID: PMC3147175
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147175/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147175/pdf/nihms203041.pdf

PHARMACOLOGICAL TREATMENT OF DEPRESSION IN DEMENTIA
Therefore,

drug interactions and polypharmacy may help provoke BPSD

in some patients with dementia,...

Given their physical and cognitive frailty,

 persons with dementia may also be particularly

 susceptible to adverse effects.

Since dementia patients may be less able to communicate, clinicians and caretakers must carefully observe patent’s behavior for evidence of adverse events when new medications are introduced.

Prescription of new medications intended to treat depression or other BPSD in dementia patients should always be made using the familiar adage originated for dosing the elderly,

“Start low and go slow”

Memantine
Memantine, ... Glutamate signaling is important for learning and memory,...

A recent review and meta-analysis

of the research on memantine for the treatment of psychological symptoms of dementia showed
 
small...


In summary, a variety of pharmacological treatments have some efficacy in the treatment of depression in dementia,

but care must be exercised in their use with this population of generally frail older persons to avoid adverse effects.

Efficacy of memantine on behavioral and psychological symptoms related to dementia: a systematic meta-analysis.
http://www.ncbi.nlm.nih.gov/pubmed/18056833

CONCLUSIONS:

However, there are a number of limitations with the current data;
 
the effect size was relatively small

 and whether memantine produces significant clinical benefit is


not clear.