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. 2021 Mar;18(3):233-240.
doi: 10.30773/pi.2020.0329. Epub 2021 Mar 10.

The Behavioral Effects of Combination Therapy of Memantine and Acetylcholinesterase Inhibitors Compared with Acetylcholinesterase Inhibitors Alone in Patients with Moderate Alzheimer's Dementia: A Double-Blind Randomized Placebo-Controlled Trial

HyunChul Youn  1 , Kang Joon Lee  2 , Shin-Gyeom Kim  1 , Seong-Jin Cho  3 , Woo Jung Kim  4 , Won Joon Lee  5 , Jae Yeon Hwang  5 , Changsu Han  6 , Cheolmin Shin  6 , Han-Yong Jung  1
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The Behavioral Effects of Combination Therapy of Memantine and Acetylcholinesterase Inhibitors Compared with Acetylcholinesterase Inhibitors Alone in Patients with Moderate Alzheimer's Dementia: A Double-Blind Randomized Placebo-Controlled Trial

HyunChul Youn et al. Psychiatry Investig. 2021 Mar.

Abstract

Objective: This study aimed to investigate treatment effects of combination therapy of memantine and acetylcholinesterase inhibitors (AchEIs) compared with AchEIs alone on behavioral and psychological symptoms of dementia (BPSD) in patients with moderate Alzheimer's dementia (AD).

Methods: This was a 12-week, double-blind, randomized, placebo-controlled trial. A total of 148 patients with moderate AD participated in this study. Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Clinician's Interview-Based Impression of Change plus caregiver input, Gottfries-Bråne-Steen Scale, and Zarit Burden Interview were used as assessment scales.

Results: There were no significant differences in age, sex, or education between AChEIs alone and combination groups. The combination group showed significantly more improvement of NPI-disinhibition score (0.76±2.15) than the AChEIs alone group (-0.14±1.71) after 12 weeks.

Conclusion: Our findings suggest that the combination therapy of memantine and AchEIs might be a beneficial option for reducing disinhibition symptoms of patients with moderate AD compared with AchEIs alone. We believe that clinicians need to consider additional memantine treatment when patients with moderate AD complain disinhibition symptom. A larger clinical trial is needed to further determine the efficacy and advantages of such combination therapy of memantine and AchEIs for treating BPSD of patients with moderate AD.

Keywords: Acetylcholinesterase inhibitors; Alzheimer’s dementia; Behavioral and psychological symptoms of dementia; Disinhibition; Memantine; Neuropsychiatric inventory.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
The schedule for assessments. MMSE: Mini-Mental State Examination, NPI: Neuropsychiatric Inventory, CIBIC-Plus: Clinician’s Interview-Based Impression of Change plus caregiver input, GBS: Gottfries– Bråne–Steen Scale, ZBI: Zarit Burden Interview.
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