The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis
Taro Kishi,* Shinji Matsunaga,* Nakao Iwata Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan *These authors contributed equally to this work Background: Memantine is effective in the treatment of behavioral disturbances in patients with Alzheimer&rs...
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Dove Medical Press
2017
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oai:doaj.org-article:3bdd7117fdeb4fec9dd35de13c7e46e92021-12-02T06:52:35ZThe effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis1178-2021https://doaj.org/article/3bdd7117fdeb4fec9dd35de13c7e46e92017-07-01T00:00:00Zhttps://www.dovepress.com/the-effects-of-memantine-on-behavioral-disturbances-in-patients-with-a-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Taro Kishi,* Shinji Matsunaga,* Nakao Iwata Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan *These authors contributed equally to this work Background: Memantine is effective in the treatment of behavioral disturbances in patients with Alzheimer’s disease. It has not yet been fully determined which behavioral disturbances respond best to memantine.Methods: We conducted a meta-analysis of memantine vs control (placebo or usual care) for the treatment of individual behavioral disturbances (delusion, hallucination, agitation/aggression, dysphoria, anxiety/phobia, euphoria, apathy, disinhibition, irritability/lability, aberrant motor activity/activity disturbances, nighttime disturbance/diurnal rhythm disturbances, and eating disturbances). Randomized controlled studies of memantine in patients with Alzheimer’s disease were included in this study. To evaluate these outcomes, standardized mean difference (SMD), with 95% confidence intervals (95% CIs), based upon a random-effects model was evaluated in the meta-analysis.Results: A total of 11 studies (n=4,261; memantine vs placebo: N=4, n=1,500; memantine + cholinesterase inhibitors [M + ChEIs] vs ChEIs: N=7, n=2,761) were included in the meta-analysis. Compared to control, memantine showed significant improvement in agitation/aggression (SMD =-0.11; 95% CIs =-0.20, -0.03; P=0.01; I2=47%), delusion (SMD =-0.12; 95% CIs =-0.18, -0.06; P=0.0002; I2=0%), disinhibition (SMD =-0.08; 95% CIs =-0.15, -0.00; P=0.04; I2=0%), and nighttime disturbance/diurnal rhythm disturbances (SMD =-0.10; 95% CIs =-0.18, -0.02; P=0.02; I2=36%). Memantine was also marginally superior to control in hallucination (SMD =-0.06; 95% CIs =-0.12, 0.01; P=0.07; I2=0%) and irritability/lability (SMD =-0.09; 95% CIs =-0.19, 0.01; P=0.07; I2=42%). Memantine is similar to control in dysphoria, anxiety/phobia, euphoria, apathy, and eating disturbance.Conclusion: The meta-analysis suggest that memantine has benefits for the treatment of most of the behavioral disturbances in patients with Alzheimer’s disease. Memantine does not deteriorate negative symptoms as behavioral disturbances in patients with Alzheimer’s disease. Keywords: memantine, Alzheimer’s disease, behavioral disturbances, meta-analysisKishi TMatsunaga SIwata NDove Medical PressarticlememantineAlzheimer’s diseasebehavioral disturbancesmeta-analysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1909-1928 (2017) |
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memantine Alzheimer’s disease behavioral disturbances meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
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memantine Alzheimer’s disease behavioral disturbances meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kishi T Matsunaga S Iwata N The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis |
| description |
Taro Kishi,* Shinji Matsunaga,* Nakao Iwata Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan *These authors contributed equally to this work Background: Memantine is effective in the treatment of behavioral disturbances in patients with Alzheimer’s disease. It has not yet been fully determined which behavioral disturbances respond best to memantine.Methods: We conducted a meta-analysis of memantine vs control (placebo or usual care) for the treatment of individual behavioral disturbances (delusion, hallucination, agitation/aggression, dysphoria, anxiety/phobia, euphoria, apathy, disinhibition, irritability/lability, aberrant motor activity/activity disturbances, nighttime disturbance/diurnal rhythm disturbances, and eating disturbances). Randomized controlled studies of memantine in patients with Alzheimer’s disease were included in this study. To evaluate these outcomes, standardized mean difference (SMD), with 95% confidence intervals (95% CIs), based upon a random-effects model was evaluated in the meta-analysis.Results: A total of 11 studies (n=4,261; memantine vs placebo: N=4, n=1,500; memantine + cholinesterase inhibitors [M + ChEIs] vs ChEIs: N=7, n=2,761) were included in the meta-analysis. Compared to control, memantine showed significant improvement in agitation/aggression (SMD =-0.11; 95% CIs =-0.20, -0.03; P=0.01; I2=47%), delusion (SMD =-0.12; 95% CIs =-0.18, -0.06; P=0.0002; I2=0%), disinhibition (SMD =-0.08; 95% CIs =-0.15, -0.00; P=0.04; I2=0%), and nighttime disturbance/diurnal rhythm disturbances (SMD =-0.10; 95% CIs =-0.18, -0.02; P=0.02; I2=36%). Memantine was also marginally superior to control in hallucination (SMD =-0.06; 95% CIs =-0.12, 0.01; P=0.07; I2=0%) and irritability/lability (SMD =-0.09; 95% CIs =-0.19, 0.01; P=0.07; I2=42%). Memantine is similar to control in dysphoria, anxiety/phobia, euphoria, apathy, and eating disturbance.Conclusion: The meta-analysis suggest that memantine has benefits for the treatment of most of the behavioral disturbances in patients with Alzheimer’s disease. Memantine does not deteriorate negative symptoms as behavioral disturbances in patients with Alzheimer’s disease. Keywords: memantine, Alzheimer’s disease, behavioral disturbances, meta-analysis |
| format |
article |
| author |
Kishi T Matsunaga S Iwata N |
| author_facet |
Kishi T Matsunaga S Iwata N |
| author_sort |
Kishi T |
| title |
The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis |
| title_short |
The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis |
| title_full |
The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis |
| title_fullStr |
The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis |
| title_full_unstemmed |
The effects of memantine on behavioral disturbances in patients with Alzheimer's disease: a meta-analysis |
| title_sort |
effects of memantine on behavioral disturbances in patients with alzheimer's disease: a meta-analysis |
| publisher |
Dove Medical Press |
| publishDate |
2017 |
| url |
https://doaj.org/article/3bdd7117fdeb4fec9dd35de13c7e46e9 |
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