Alzheimer's Drug Offers Hope Where Little Exists Study Suggests Memantine Improves Mental Activity, Function

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By Peggy Peck
WebMD Medical News

Reviewed by Dr. Dominique S. Walton

(Washington) -- Jean, a former award-winning elementary school teacher, passes her days looking out at her front garden and the Lakewood, Ohio, street where she has lived for close to five decades. It is July, and for years, July meant a trip back to Vermont where Jean grew up and where many of her distant cousins still live. But Jean hasn't visited Vermont for almost 10 years, even though she asks every day to "go home." Jean has advanced Alzheimer's disease, and it's unclear how much longer her husband and grown children will be able to take care of her in her own home.

Barry Reisberg, MD, says an experimental drug called memantine may someday be able to help people like Jean and millions of other Alzheimer's patients who are still living at home and who become more difficult to manage each day. It is patients at this stage of the disease, called stage 6, who "become the biggest burden to caregivers," Reisberg says. He says that most patients take about three and half years to progress to this stage. At this point, the patient needs help dressing and bathing, and will eventually become incontinent. The patients also become "difficult, agitated, acting out," Reisberg says. He says this new drug can actually improve some of those symptoms and help slow down the progression of the disease.

He is expected to present results of the study that compares the drug to a placebo in more than 250 patients with moderate to severe Alzheimer's disease. He tells WebMD that after seven months of treatment with the drug, patients taking it scored better on tests of mental activity and function than patients who were randomized to the placebo. "That's significant," he says. Reisberg, professor of psychiatry at New York University School of Medicine, says that the drug was well-tolerated and actually "more people withdrew from the placebo [group] than from the treatment [group]."

Reisberg says the FDA has approved three drugs for treatment of mild Alzheimer's disease. But those drugs all work on the same messaging system in the brain. "Those drugs all attempt to increase the amount of a chemical that carries messages in the brain," he says.

Memantine works differently. It targets a certain brain receptor that Reisberg and other scientists think may be the true site of memory. He says that when mice were genetically altered so that this receptor wasstimulated, "they became smarter mice." While he doesn't think the drug will make smarter humans, he does think it offers real hope to a group that "have never been treated."

Bill Thies, PhD, vice president for medical and scientific affairs at the Alzheimer's Association, said a drug designed to treat moderate to severe Alzheimer's would be a major breakthrough "because there are currently no approved treatments for these patients." He says, too, that it is among this group of patients that the burden is greatest on the caregivers so a treatment also would offer some relief for them.

Reisberg says the drug is not yet available in the U.S., but the manufacturer, Merz, recently signed an agreement with a U.S. partner to pursue FDA approval. He says the drug is available in Germany, where it is used to treat what he described as "general dementia."