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Memantine for dementia in people with Down syndrome

Memantine is thought to improve cognitive function and slow the decline of AD over time.The effects of memantine on AD are reported to be beneficial for people with moderate to severe AD in the general population, However, people with DS tend to present with AD at a much younger age than the general population as well as being physically different in terms of size, metabolism and heart rate, and may therefore have different requirements. Results from the one randomised controlled trial for the treatment of dementia in DS are not yet available (expected 2009).

This review was superseded by a new review titled 'P harmacological interventions for cognitive decline in people with Down syndrome' in the CDSR in 2015.

Uvod

Alzheimer's dementia (AD) is the most common form of dementia in people with Down Syndrome (DS). There is an understanding that an increase in L-glutamate contributes to the pathogenesis of cerebral ischemias and AD. Memantine acts as an antagonist of N-methyl-D-aspartate (NMDA) type receptors, which is thought to reduce abnormal activation of glutamate neurotransmission. It binds with a low affinity to the NMDA receptor and so should not prevent learning and the formation of memory. Memantine can improve cognitive function and slow the decline of AD in the general population over time, and is the subject of this review. It is important to note that people with DS tend to present with AD at a much younger age than the normal population as well as having subtle differences in physiology (e.g. metabolism and heart rate) and may therefore have different requirements from the general population. This review was superseded by a new review titled ' Pharmacological interventions for cognitive decline in people with Down syndrome' in the Cochrane Database of Systematic Reviews (CDSR) in 2015.

Ciljevi

To determine the effectiveness and safety of memantine for people with DS who develop AD.

Metode pretraživanja

CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, BIOSIS, SCI, SSCI and the NRR were searched up to October 2008. We contacted the manufacturers of memantine, as well as experts in the field, to ask about reports of unpublished or ongoing trials.

Kriteriji odabira

Randomised controlled trials of participants with DS and AD in which treatment with memantine was administered compared with a placebo group.

Prikupljanje podataka i obrada

No study was identified which met the inclusion criteria for this review.

Glavni rezultati

No study was identified which met inclusion criteria for this review, however there is an on-going randomised controlled study being conducted in the UK and data are expected in 2009.

Zaključak autora

As there are no included trials, recommendations cannot be made about memantine for AD in DS. Well-designed, adequately powered studies are required.

Citat
Mohan M, Bennett C, Carpenter PK. Memantine for dementia in people with Down syndrome. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD007657. DOI: 10.1002/14651858.CD007657.

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