Kendall Shirey
The University of Texas Medical Branch, Galveston, Texas Department of Physician Assistant Studies
Title: Neuro-Ophthalmology
Biography
Biography: Kendall Shirey
Abstract
Donepezil, an acetylcholinesterase inhibitor, is a commonly prescribed drug in Alzheimer’s dementia patients used to slow disease progression.8 Memantine, a N-methyl-Daspartate antagonist, can be used as an adjunct with Donepezil to improve symptoms.8 The purpose of this analysis is to determine the efficacy of combined Donepezil and Memantine in comparison to Donepezil monotherapy at slowing the progression of cognitive impairment in Alzheimer’s disease as measured by serial mini mental status exams.
Methods: An electronic search was conducted using PubMed and Google Scholar databases. Articles chosen evaluated the efficacy of combined treatment of Donepezil and Memantine versus Donepezil monotherapy on slowing the progression of cognitive impairment in AD. Studies used mini mental status exams (MMSEs) to assess cognitive decline.
Results: Eleven studies were analyzed to assess the effect of Donepezil alone versus Donepezil and Memantine combination therapy for the treatment of Alzheimer’s dementia. An aggregate of 4,720 patients were included in our analysis. A large majority of the studies revealed that there was no significant statistical benefit of combination therapy compared to Donepezil monotherapy based on MMSE scores and clinical outcome. However, combination therapy was indeed found to help improve cognitive function and reduce neuropsychiatric symptoms, particularly in patients with moderate to severe Alzheimer’s dementia.
Conclusion: In conclusion, combination therapy is superior to monotherapy in patients with moderate to severe AD as assessed by MMSEs despite a lack of strong statistical significance between the two drug regimens. In a patient with mild AD, the addition of Memantine to the acetylcholinesterase inhibitor therapeutic framework does not appear to be of any clinical benefit, but further research needs to be performed to make this determination.