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Revision as of 09:45, 21 November 2011 editBeetstra (talk | contribs)Edit filter managers, Administrators172,031 edits Saving copy of the {{drugbox}} taken from revid 461653106 of page Memantine for the Chem/Drugbox validation project (updated: 'DrugBank').  Latest revision as of 15:43, 13 December 2024 edit Back ache (talk | contribs)Extended confirmed users9,885 edits →Adverse effects: linked some termsTag: Visual edit 
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{{Short description|Medication used to treat Alzheimer's disease}}
{{ambox | text = This page contains a copy of the infobox ({{tl|drugbox}}) taken from revid of page ] with values updated to verified values.}}
{{Use dmy dates|date=February 2024}}
{{cs1 config|name-list-style=vanc|display-authors=6}}
{{Drugbox {{Drugbox
| verifiedrevid = 416282523 | verifiedrevid = 461742099
| image = Memantine structure.svg
| IUPAC_name = 3,5-dimethyltricyclodecan-1amine<br />or<br />3,5-dimethyladamantan-1-amine
| image = Memantine.svg
| width = 150 | width = 150
| image2 = Memantine-3d-sticks.png | image2 = Memantine ball-and-stick model.png
| width2 = 185


<!--Clinical data--> <!-- Clinical data -->
| pronounce =
| tradename = Namenda
| tradename = Axura, Ebixa, Namenda, others<ref name=brands/><ref name="IndexNominum2004">{{cite book | author=Schweizerischer Apotheker-Verein | title=Index Nominum: International Drug Directory | publisher=Medpharm Scientific Publishers | year=2004 | isbn=978-3-88763-101-7 | url=https://books.google.com/books?id=EgeuA47Ocm4C&pg=PA753 | access-date=12 September 2024 | page=753}}</ref>
| Drugs.com = {{drugs.com|monograph|memantine-hydrochloride}} | Drugs.com = {{drugs.com|monograph|memantine-hydrochloride}}
| MedlinePlus = a604006 | MedlinePlus = a604006
| licence_EU = Axura | DailyMedID = Memantine
| licence_US = Namenda | pregnancy_AU = B2
| pregnancy_AU_comment =
| pregnancy_category = B2 <small>(])</small>, B <small>(])</small>
| pregnancy_category =
| legal_status = S4 <small>(Au)</small>, POM <small>(])</small>, ℞-only <small>(U.S.)</small>
| routes_of_administration = Oral | routes_of_administration = ]
| class = ]
| ATC_prefix = N06
| ATC_suffix = DX01
| ATC_supplemental =

<!-- Legal status -->
| legal_AU = S4
| legal_BR = C1
| legal_BR_comment = <ref>{{cite web |author=Anvisa |author-link=Brazilian Health Regulatory Agency |date=31 March 2023 |title=RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial |trans-title=Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control|url=https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |url-status=live |archive-url=https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992 |archive-date=3 August 2023 |access-date=16 August 2023 |publisher=] |language=pt-BR |publication-date=4 April 2023}}</ref>
| legal_UK = POM
| legal_UK_comment = <ref>{{cite web | title= Ebixa 10 mg film-coated tablets Summary of Product Characteristics (SmPC) | website=(emc) | date=13 December 2021 | url=https://www.medicines.org.uk/emc/product/8222/smpc | access-date=2 May 2024}}</ref>
| legal_US = Rx-only
| legal_US_comment = <ref>{{cite web | title=Namenda- memantine hydrochloride tablet; Namenda- memantine hydrochloride kit | website=DailyMed | date=1 November 2018 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b9f27baf-aa2a-443a-9ef5-e002d23407ba | access-date=2 May 2024}}</ref><ref>{{cite web | title=Namenda XR- memantine hydrochloride capsule, extended release; Namenda XR- memantine hydrochloride kit | website=DailyMed | date=15 November 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=710f523f-0158-4639-8ce7-57598247d48c | access-date=2 May 2024}}</ref>
| legal_EU = Rx-only
| legal_EU_comment = <ref name="Axura EPAR">{{cite web | website=] (EMA) | title=Axura EPAR | date=17 May 2002 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/axura | access-date=27 February 2024}}</ref>


<!--Pharmacokinetic data--> <!-- Pharmacokinetic data -->
| bioavailability = 100%<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007">{{cite journal | vauthors = Schmitt F, Ryan M, Cooper G | title = A brief review of the pharmacologic and therapeutic aspects of memantine in Alzheimer's disease | journal = Expert Opin Drug Metab Toxicol | volume = 3 | issue = 1 | pages = 135–141 | date = February 2007 | pmid = 17269900 | doi = 10.1517/17425255.3.1.135 | url = }}</ref>
| bioavailability = ~100%
| protein_bound = 45%<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" />
| metabolism = ] (<10%)
| metabolism = Minimal<ref name="SchmittRyanCooper2007" />
| elimination_half-life = 60–100 hours
| metabolites = • Memantine glucuronide<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /><br />• 6-Hydroxymemantine<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /><br />• 1-Nitrosomemantine<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" />
| excretion = ]
| elimination_half-life = 60–80 hours<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" />
| excretion = ] (57–82% unchanged)<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" />


<!--Identifiers--> <!-- Identifiers -->
| index2_label = as HCl
| CASNo_Ref = {{cascite|correct|CAS}}
| IUPHAR_ligand = 4253
| CAS_number_Ref = {{cascite|correct|??}} | CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 19982-08-2 | CAS_number = 19982-08-2
| CAS_number2 = 41100-52-1
| ATC_prefix = N06
| ATC_suffix = DX01
| PubChem = 4054 | PubChem = 4054
| PubChem2 = 181458
| DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB01043 | DrugBank = DB01043
| DrugBank2 = DBSALT000456
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 3914 | ChemSpiderID = 3914
| ChemSpiderID2 = 157849
| UNII_Ref = {{fdacite|correct|FDA}} | UNII_Ref = {{fdacite|correct|FDA}}
| UNII = W8O17SJF3T | UNII = W8O17SJF3T
| UNII2 = JY0WD0UA60
| KEGG_Ref = {{keggcite|correct|kegg}} | KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D08174 | KEGG = D08174
| KEGG2 = D04905
| ChEBI = 64312
| ChEBI2 = 64323
| ChEMBL_Ref = {{ebicite|correct|EBI}} | ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 807 | ChEMBL = 807
| ChEMBL2 = 1699
| NIAID_ChemDB =
| PDB_ligand = 377
| synonyms = 1-Amino-3,5-dimethyladamantane; 3,5-Dimethyladamantan-1-amine; Dimethyladamantanamine; DMAA; D145; D-145


<!--Chemical data--> <!-- Chemical data -->
| IUPAC_name = 3,5-dimethyltricyclodecan-1-amine
| C=12 | H=21 | N=1
| C = 12
| molecular_weight = 179.3 g/mol
| H = 21
| smiles = NC12CC3(CC(C1)(CC(C2)C3)C)C
| N = 1
| InChI = 1/C12H21N/c1-10-3-9-4-11(2,6-10)8-12(13,5-9)7-10/h9H,3-8,13H2,1-2H3
| SMILES = NC12CC3CC(C)(C1)CC(C)(C3)C2
| InChIKey = BUGYDGFZZOZRHP-UHFFFAOYAK
| SMILES2 = Cl.NC12CC3CC(C)(C1)CC(C)(C3)C2
| StdInChI_Ref = {{stdinchicite|correct|chemspider}} | StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C12H21N/c1-10-3-9-4-11(2,6-10)8-12(13,5-9)7-10/h9H,3-8,13H2,1-2H3 | StdInChI = 1S/C12H21N/c1-10-3-9-4-11(2,6-10)8-12(13,5-9)7-10/h9H,3-8,13H2,1-2H3
| StdInChI2 = 1S/C12H21N.ClH/c1-10-3-9-4-11(2,6-10)8-12(13,5-9)7-10;/h9H,3-8,13H2,1-2H3;1H
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} | StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = BUGYDGFZZOZRHP-UHFFFAOYSA-N | StdInChIKey = BUGYDGFZZOZRHP-UHFFFAOYSA-N
| StdInChIKey2 = LDDHMLJTFXJGPI-UHFFFAOYSA-N
}} }}
<!-- Definition and medical uses -->
'''Memantine''', sold under the brand name '''Namenda''' among others, is a medication used to slow the progression of moderate-to-severe ].<ref name=AHFS2019/><ref name=BNF76>{{cite book|title=British national formulary : BNF 76|date=2018|publisher=Pharmaceutical Press|isbn=9780857113382|pages=303–304|edition=76}}</ref><ref name="AlamLingenfelterBender2017">{{cite journal | vauthors = Alam S, Lingenfelter KS, Bender AM, Lindsley CW | title = Classics in Chemical Neuroscience: Memantine | journal = ACS Chem Neurosci | volume = 8 | issue = 9 | pages = 1823–1829 | date = September 2017 | pmid = 28737885 | doi = 10.1021/acschemneuro.7b00270 | url = }}</ref> It is taken ].<ref name=AHFS2019/><ref name="AlamLingenfelterBender2017" />

<!-- Side effects, mechanism of action, and chemistry -->
Common ]s include ], ], ], and ].<ref name=AHFS2019/><ref name=BNF76/> Severe side effects may include ]s, ], and ].<ref name=BNF76/> It is believed to work by acting on ]s, working as a ] of these ]s.<ref name="AlamLingenfelterBender2017" /><ref name=AHFS2019>{{cite web |title=Memantine Hydrochloride Monograph for Professionals |url=https://www.drugs.com/monograph/memantine-hydrochloride.html |website=Drugs.com |publisher=American Society of Health-System Pharmacists |access-date=3 March 2019 |archive-date=25 April 2019 |archive-url=https://web.archive.org/web/20190425032939/https://www.drugs.com/monograph/memantine-hydrochloride.html |url-status=live }}</ref>

<!-- History, society, and culture -->
Memantine was first discovered in 1963.<ref name="AlamLingenfelterBender2017" /><ref name="Río-Sancho2020">{{cite book | vauthors = del Río-Sancho S | title=Diagnosis and Management in Dementia | chapter=Memantine and Alzheimer's disease | publisher=Elsevier | date=2020 | isbn=978-0-12-815854-8 | doi=10.1016/b978-0-12-815854-8.00032-x | pages=511–527}}</ref><ref name="HerrmannLiLanctôt2011">{{cite journal | vauthors = Herrmann N, Li A, Lanctôt K | title = Memantine in dementia: a review of the current evidence | journal = Expert Opinion on Pharmacotherapy | volume = 12 | issue = 5 | pages = 787–800 | date = April 2011 | pmid = 21385152 | doi = 10.1517/14656566.2011.558006 }}</ref> It was approved for medical use in ] in 1989, in the ] in 2002, and in the ] in 2003.<ref name="HerrmannLiLanctôt2011" /><ref name=AHFS2019/><ref name="NRDD" /> It is available as a ].<ref name=BNF76/> In 2022, it was the 150th most commonly prescribed medication in the United States, with more than 3{{nbsp}}million prescriptions.<ref name="Top 300">{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref>{{cite web | title = Memantine Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/Memantine | access-date = 30 August 2024 }}</ref>

== Medical uses ==
===Alzheimer's disease and dementia===
Memantine is used to treat moderate-to-severe Alzheimer's disease, especially for people who are intolerant of or have a contraindication to ] ].<ref name=MountC2006>{{cite journal | vauthors = Mount C, Downton C | title = Alzheimer disease: progress or profit? | journal = Nature Medicine | volume = 12 | issue = 7 | pages = 780–784 | date = July 2006 | pmid = 16829947 | doi = 10.1038/nm0706-780 | s2cid = 31877708 | doi-access = }}</ref><ref name="NICE Guidelines">NICE review of technology appraisal guidance 111 January 18, 2011 {{Webarchive|url=https://web.archive.org/web/20190321090243/https://www.nice.org.uk/guidance/ta217/resources/alzheimers-disease-donepezil-galantamine-rivastigmine-and-memantine-review-final-appraisal-determination2 |date=21 March 2019 }}</ref> One guideline recommends memantine or an AChE inhibitor be considered in people in the early-to-mid stage of dementia.<ref>{{cite journal | vauthors = Page AT, Potter K, Clifford R, McLachlan AJ, Etherton-Beer C | title = Medication appropriateness tool for co-morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel | journal = Internal Medicine Journal | volume = 46 | issue = 10 | pages = 1189–1197 | date = October 2016 | pmid = 27527376 | pmc = 5129475 | doi = 10.1111/imj.13215 }}</ref>

Memantine has been associated with a modest improvement;<ref name="AMH2006" /> with small positive effects on ], mood, behavior, and the ability to perform daily activities in moderate-to-severe Alzheimer's disease.<ref>{{cite journal | vauthors = McShane R, Westby MJ, Roberts E, Minakaran N, Schneider L, Farrimond LE, Maayan N, Ware J, Debarros J | title = Memantine for dementia | journal = The Cochrane Database of Systematic Reviews | volume = 3 | pages = CD003154 | date = March 2019 | issue = 3 | pmid = 30891742 | pmc = 6425228 | doi = 10.1002/14651858.CD003154.pub6 }}</ref><ref>{{cite journal | vauthors = van Dyck CH, Tariot PN, Meyers B, Malca Resnick E | title = A 24-week randomized, controlled trial of memantine in patients with moderate-to-severe Alzheimer disease | journal = Alzheimer Disease and Associated Disorders | volume = 21 | issue = 2 | pages = 136–143 | date = 2007 | pmid = 17545739 | doi = 10.1097/WAD.0b013e318065c495 | s2cid = 25621202 | authorlink1 = Christopher H. van Dyck }}</ref> There does not appear to be any benefit in mild disease.<ref name=Review11>{{cite journal | vauthors = Schneider LS, Dagerman KS, Higgins JP, McShane R | title = Lack of evidence for the efficacy of memantine in mild Alzheimer disease | journal = Archives of Neurology | volume = 68 | issue = 8 | pages = 991–998 | date = August 2011 | pmid = 21482915 | doi = 10.1001/archneurol.2011.69 | s2cid = 18870666 | doi-access = }}</ref>

Memantine when added to ] in those with moderate-to-severe dementia resulted in "limited improvements" in a 2017 review.<ref name="Chen2017">{{cite journal | vauthors = Chen R, Chan PT, Chu H, Lin YC, Chang PC, Chen CY, Chou KR | title = Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis | journal = PLOS ONE | volume = 12 | issue = 8 | pages = e0183586 | date = 21 August 2017 | pmid = 28827830 | pmc = 5565113 | doi = 10.1371/journal.pone.0183586 | doi-access = free | bibcode = 2017PLoSO..1283586C | veditors = Chen K }}</ref> The UK ] (NICE) issued guidance in 2018 recommending consideration of the combination of memantine with donepezil in those with moderate-to-severe dementia.<ref>{{cite web|title=Dementia: assessment, management and support for people living with dementia and their carers |url=https://www.nice.org.uk/guidance/ng97|date=20 June 2018 | access-date=6 August 2020|website=National Institute for Health and Care Excellence (NICE) |archive-date=12 August 2020|archive-url=https://web.archive.org/web/20200812135035/https://www.nice.org.uk/guidance/ng97|url-status=live}}</ref>

=== Radiation therapy ===
Memantine has been recommended for use by professional organization consensus to prevent neurocognitive decline after ].<ref>{{cite journal | vauthors = Vogelbaum MA, Brown PD, Messersmith H, Brastianos PK, Burri S, Cahill D, Dunn IF, Gaspar LE, Gatson NT, Gondi V, Jordan JT, Lassman AB, Maues J, Mohile N, Redjal N, Stevens G, Sulman E, van den Bent M, Wallace HJ, Weinberg JS, Zadeh G, Schiff D | title = Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline | journal = Journal of Clinical Oncology | volume = 40 | issue = 5 | pages = 492–516 | date = February 2022 | pmid = 34932393 | doi = 10.1200/JCO.21.02314 | s2cid = 245385315 | doi-access = free }}</ref>

== Adverse effects ==
Memantine is, in general, well tolerated.<ref name=AMH2006/> Common ]s (≥1% of people) include confusion, dizziness, drowsiness, headache, insomnia, agitation, and/or hallucinations. Less common adverse effects include ], anxiety, ], ], and increased ].<ref name=AMH2006>Rossi S, editor. ] 2006. Adelaide: Australian Medicines Handbook; 2006.</ref><ref name=BNF47>{{cite book |author=Joint Formulary Committee |title=British National Formulary |publisher=BMA and the Royal Pharmaceutical Society of Great Britain |location=London |year=2004 |isbn=978-0-85369-584-4 |edition=47th|title-link=British National Formulary }}</ref>

Like many other ]s, memantine behaves as a ] at supratherapeutic doses.<ref name=Morris>{{cite journal | vauthors = Morris H, Wallach J | title = From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs | journal = Drug Testing and Analysis | volume = 6 | issue = 7–8 | pages = 614–632 | year = 2014 | pmid = 24678061 | doi = 10.1002/dta.1620 }}</ref> Despite isolated reports, ] of memantine is rare due to the drug's long duration and limited availability.<ref name="Morris"/> Additionally, memantine seems to lack effects such as ] or ].<ref>{{cite journal | vauthors = Swedberg MD, Ellgren M, Raboisson P | title = mGluR5 antagonist-induced psychoactive properties: MTEP drug discrimination, a pharmacologically selective non-NMDA effect with apparent lack of reinforcing properties | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 349 | issue = 1 | pages = 155–164 | date = April 2014 | pmid = 24472725 | doi = 10.1124/jpet.113.211185 | s2cid = 787751 }}</ref>

Memantine appears to be generally well tolerated by children with ].<ref name="Elbe 2019 p. ">{{cite book | vauthors = Elbe D | title=Clinical handbook of psychotropic drugs for children and adolescents | publisher=Hogrefe | location=Boston, MA | year=2019 | isbn=978-1-61676-550-7 | oclc=1063705924 | pages=366–369 | type=]}}</ref>

== Pharmacology ==

=== Pharmacodynamics ===

==== Glutamatergic ====
A dysfunction of ] ], manifested as ]al ], is hypothesized to be involved in the ] of ]. Targeting the glutamatergic system, specifically ] ]s, offers a novel approach to treatment in view of the limited efficacy of existing drugs targeting the ] system.<ref name=Cacabelos1999>{{cite journal | vauthors = Cacabelos R, Takeda M, Winblad B | title = The glutamatergic system and neurodegeneration in dementia: preventive strategies in Alzheimer's disease | journal = International Journal of Geriatric Psychiatry | volume = 14 | issue = 1 | pages = 3–47 | date = January 1999 | pmid = 10029935 | doi = 10.1002/(SICI)1099-1166(199901)14:1<3::AID-GPS897>3.0.CO;2-7 | s2cid = 12141540 }}</ref>

Memantine is a low-affinity voltage-dependent ] ].<ref name=Rogawski2003 >{{cite journal | vauthors = Rogawski MA, Wenk GL | title = The neuropharmacological basis for the use of memantine in the treatment of Alzheimer's disease | journal = CNS Drug Reviews | volume = 9 | issue = 3 | pages = 275–308 | year = 2003 | pmid = 14530799 | pmc = 6741669 | doi = 10.1111/j.1527-3458.2003.tb00254.x }}</ref><ref name=Robinson>{{cite journal | vauthors = Robinson DM, Keating GM | title = Memantine: a review of its use in Alzheimer's disease | journal = Drugs | volume = 66 | issue = 11 | pages = 1515–1534 | year = 2006 | pmid = 16906789 | doi = 10.2165/00003495-200666110-00015 | s2cid = 212617566 }}</ref> By binding to the NMDA receptor with a higher affinity than ] ions, memantine is able to inhibit the prolonged influx of ] ions, particularly from extrasynaptic receptors, which forms the basis of neuronal ]. The low affinity, uncompetitive nature, and rapid off-rate kinetics of memantine at the level of the NMDA receptor channel, however, preserves the function of the receptor at synapses, as it can still be activated by physiological release of ] following ] of the ] neuron.<ref>{{cite journal | vauthors = Xia P, Chen HS, Zhang D, Lipton SA | title = Memantine preferentially blocks extrasynaptic over synaptic NMDA receptor currents in hippocampal autapses | journal = The Journal of Neuroscience | volume = 30 | issue = 33 | pages = 11246–11250 | date = August 2010 | pmid = 20720132 | pmc = 2932667 | doi = 10.1523/JNEUROSCI.2488-10.2010 }}</ref><ref name=Parsons2007>{{cite journal | vauthors = Parsons CG, Stöffler A, Danysz W | title = Memantine: a NMDA receptor antagonist that improves memory by restoration of homeostasis in the glutamatergic system--too little activation is bad, too much is even worse | journal = Neuropharmacology | volume = 53 | issue = 6 | pages = 699–723 | date = November 2007 | pmid = 17904591 | doi = 10.1016/j.neuropharm.2007.07.013 | s2cid = 6599658 }}</ref><ref name=Lipton2007>{{cite journal | vauthors = Lipton SA | title = Pathologically activated therapeutics for neuroprotection | journal = Nature Reviews. Neuroscience | volume = 8 | issue = 10 | pages = 803–808 | date = October 2007 | pmid = 17882256 | doi = 10.1038/nrn2229 | s2cid = 34931289 }}</ref> The interaction of memantine with NMDA receptors plays a major role in the symptomatic improvement that the drug produces in Alzheimer's disease. However, there is no evidence as yet that the ability of memantine to protect against extrasynaptic NMDA receptor-mediated excitotoxicity has a disease-modifying effect in Alzheimer's disease, although this has been suggested in animal models.<ref name=Parsons2007/>

==== Serotonergic ====
Memantine acts as a ] of the ] ], with a ] similar to that for the NMDA receptor.<ref name=Rammes2001>{{cite journal | vauthors = Rammes G, Rupprecht R, Ferrari U, Zieglgänsberger W, Parsons CG | title = The N-methyl-D-aspartate receptor channel blockers memantine, MRZ 2/579 and other amino-alkyl-cyclohexanes antagonise 5-HT(3) receptor currents in cultured HEK-293 and N1E-115 cell systems in a non-competitive manner | journal = Neuroscience Letters | volume = 306 | issue = 1–2 | pages = 81–84 | date = June 2001 | pmid = 11403963 | doi = 10.1016/S0304-3940(01)01872-9 | s2cid = 9655208 }}</ref> Many 5-HT<sub>3</sub> receptor antagonists function as ]s, however the clinical significance of this ] activity of memantine in Alzheimer's disease is unknown.

==== Cholinergic ====
Memantine acts as a ] of different neuronal ]s (nAChRs) at potencies possibly similar to the NMDA receptor and 5-HT<sub>3</sub> receptor, but this is difficult to ascertain with accuracy because of the rapid desensitization of nAChR responses in these experiments. It can be noted that memantine is an antagonist at ], which may contribute to initial worsening of cognitive function during early memantine treatment. α<sub>7</sub> nAChR ]s quickly in response to antagonism, which could explain the cognitive-enhancing effects of chronic memantine treatment.<ref name=Buisson1998>{{cite journal | vauthors = Buisson B, Bertrand D | title = Open-channel blockers at the human alpha4beta2 neuronal nicotinic acetylcholine receptor | journal = Molecular Pharmacology | volume = 53 | issue = 3 | pages = 555–563 | date = March 1998 | pmid = 9495824 | doi = 10.1124/mol.53.3.555 | s2cid = 5865674 }}</ref><ref name=Aracava2005>{{cite journal | vauthors = Aracava Y, Pereira EF, Maelicke A, Albuquerque EX | title = Memantine blocks alpha7* nicotinic acetylcholine receptors more potently than n-methyl-D-aspartate receptors in rat hippocampal neurons | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 312 | issue = 3 | pages = 1195–1205 | date = March 2005 | pmid = 15522999 | doi = 10.1124/jpet.104.077172 | s2cid = 17585264 }}</ref> It has been shown that the number of ]s in the brain are reduced in Alzheimer's disease, even in the absence of a general decrease in the number of neurons, and ] ] are viewed as interesting targets for anti-Alzheimer drugs.<ref name=Gotti2004>{{cite journal | vauthors = Gotti C, Clementi F | title = Neuronal nicotinic receptors: from structure to pathology | journal = Progress in Neurobiology | volume = 74 | issue = 6 | pages = 363–396 | date = December 2004 | pmid = 15649582 | doi = 10.1016/j.pneurobio.2004.09.006 | s2cid = 24093369 }}</ref>

==== Dopaminergic ====
Memantine was shown in a study to act as an agonist at the ] ] with equal or slightly higher affinity than to the NMDA receptors.<ref name="SeemanCarusoLasaga2008">{{cite journal | vauthors = Seeman P, Caruso C, Lasaga M | title = Memantine agonist action at dopamine D2High receptors | journal = Synapse | volume = 62 | issue = 2 | pages = 149–153 | date = February 2008 | pmid = 18000814 | doi = 10.1002/syn.20472 | hdl = 11336/108388 | s2cid = 20494427 | hdl-access = free }}</ref> However, the relevance of this action may be negligible, as studies have shown very low affinity for binding to D<sub>2</sub> receptors in general.<ref>{{cite web |title=Memantine Ki values |url=https://pdsp.unc.edu/databases/pdsp.php?receptorDD=&receptor=&speciesDD=&species=&sourcesDD=&source=&hotLigandDD=&hotLigand=&testLigandDD=&testFreeRadio=testFreeRadio&testLigand=Memantine&referenceDD=&reference=&KiGreater=&KiLess=&kiAllRadio=all&doQuery=Submit+Query |website=PDSP Ki Database |publisher=UNC |access-date=30 July 2022 |archive-date=30 July 2022 |archive-url=https://web.archive.org/web/20220730221932/https://pdsp.unc.edu/databases/pdsp.php?receptorDD=&receptor=&speciesDD=&species=&sourcesDD=&source=&hotLigandDD=&hotLigand=&testLigandDD=&testFreeRadio=testFreeRadio&testLigand=Memantine&referenceDD=&reference=&KiGreater=&KiLess=&kiAllRadio=all&doQuery=Submit+Query |url-status=live }}</ref>

==== Sigmaergic ====
Memantine acts as an ] of the ] ] with low ] (K<sub>i</sub> = 2.6{{nbsp}}μM).<ref name="pmid15090047">{{cite journal | vauthors = Peeters M, Romieu P, Maurice T, Su TP, Maloteaux JM, Hermans E | title = Involvement of the sigma 1 receptor in the modulation of dopaminergic transmission by amantadine | journal = The European Journal of Neuroscience | volume = 19 | issue = 8 | pages = 2212–2220 | date = April 2004 | pmid = 15090047 | doi = 10.1111/j.0953-816X.2004.03297.x | s2cid = 19479968 }}</ref> The consequences of this activity are unclear (as the role of sigma receptors in general is currently not very well understood). Due to this low affinity, therapeutic concentrations of memantine are most likely too low to have any sigmaergic effect as a typical therapeutic dose is 20&nbsp;mg. However, excessive doses of memantine taken for recreational purposes many times greater than prescribed doses may indeed activate this receptor.<ref>{{cite web|url=https://erowid.org/experiences/subs/exp_Pharms_Memantine.shtml|title=Pharms - Memantine (also Namenda) : Erowid Exp: Main Index|website=erowid.org|access-date=7 November 2018|archive-date=7 November 2018|archive-url=https://web.archive.org/web/20181107104302/https://erowid.org/experiences/subs/exp_Pharms_Memantine.shtml|url-status=live}}</ref>

==== Other actions ====
Memantine does not appear to ] or ] several ] ]s including ]/], ], ], and ].<ref name="AlamLingenfelterBender2017" /> It also does not inhibit ] or ].<ref name="SchmittRyanCooper2007" /> However, it might have a small effect on ].<ref name="AlamLingenfelterBender2017" />

=== Pharmacokinetics ===

==== Absorption ====
The ] ] of memantine is 100%.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> ] levels of memantine is 3 to 7{{nbsp}}hours.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> ] has no influence on the rate of ].<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> Memantine exposure is linear over a dose range of 10 to 40{{nbsp}}mg.<ref name="AlamLingenfelterBender2017" /> ] levels after a single 20{{nbsp}}mg dose were found to be 24 to 29{{nbsp}}μg/L (0.13–0.16{{nbsp}}μmol/L or μM).<ref name="AlamLingenfelterBender2017" /> ] of memantine with 20{{nbsp}}mg/day are in the range of 0.5 to 1.0{{nbsp}}μM.<ref name="SchmittRyanCooper2007" />

==== Distribution ====
Memantine has a relatively high ] (V<sub>d</sub>) of 9 to 11{{nbsp}}L/kg.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> It easily crosses ]s, is widely ] throughout the body, and crosses the ] into the ].<ref name="SchmittRyanCooper2007" /> The drug is ] across the blood–brain barrier by the ] (OCTN1).<ref name="AlamLingenfelterBender2017" /> The ] of memantine is 45% and is described as very low and not clinically significant.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> Because of its low plasma protein binding, it is unlikely to interact with other highly protein-bound drugs such as ] or ].<ref name="SchmittRyanCooper2007" />

==== Metabolism ====
Memantine does not undergo extensive ].<ref name="SchmittRyanCooper2007" /> It is negligibly ] by the ] ]s.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> As a result, it has a decreased potential for ]s.<ref name="SchmittRyanCooper2007" /> ]s of memantine include memantine glucuronide, 6-hydroxymemantine, and 1-nitrosomemantine, all of which show minimal activity as NMDA receptor antagonists.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" />

==== Elimination ====
Memantine is ] primarily in ], with 57 to 82% ] in urine unchanged.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> Its ] is 60 to 80{{nbsp}}hours.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> The ] ] of memantine is dependent on ] ].<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" /> More ] urine slows the elimination of memantine, whereas more ]ic urine accelerates its elimination.<ref name="AlamLingenfelterBender2017" /><ref name="SchmittRyanCooper2007" />

== Chemistry ==
Memantine, also known as 3,5-dimethyl-1-aminoadamantane (DMAA), is an ] ] and is closely ] to ] (1-aminoadamantane) and other adamantane derivatives.<ref name="AlamLingenfelterBender2017" /><ref name="RagshaniyaKumarTittal2024">{{cite journal | vauthors = Ragshaniya A, Kumar V, Tittal RK, Lal K | title = Nascent pharmacological advancement in adamantane derivatives | journal = Arch Pharm (Weinheim) | volume = 357 | issue = 3 | pages = e2300595 | date = March 2024 | pmid = 38128028 | doi = 10.1002/ardp.202300595 | url = }}</ref><ref name="DanyszDekundyScheschonka2021">{{cite journal | vauthors = Danysz W, Dekundy A, Scheschonka A, Riederer P | title = Amantadine: reappraisal of the timeless diamond-target updates and novel therapeutic potentials | journal = J Neural Transm (Vienna) | volume = 128 | issue = 2 | pages = 127–169 | date = February 2021 | pmid = 33624170 | pmc = 7901515 | doi = 10.1007/s00702-021-02306-2 | url = }}</ref><ref name="MorozovIvanovaLukicheva2001">{{cite journal | vauthors = Morozov IS, Ivanova IA, Lukicheva TA | title=[Actoprotector and adaptogen properties of adamantane derivatives (a review). | journal=Pharmaceutical Chemistry Journal | volume=35 | issue=5 | date=2001 | doi=10.1023/A:1011905302667 | pages=235–238}}</ref>

The ] of memantine has been described.<ref name="AlamLingenfelterBender2017" />

== History ==
{{Main|Discovery and development of memantine and related compounds}}

Memantine was first ], ]ed, and described by ] in 1963 as an ], but it was ineffective at lowering ].<ref name="AlamLingenfelterBender2017" /><ref name="Río-Sancho2020" /><ref name="HerrmannLiLanctôt2011" /><ref name="GerzonKrumkalnsBrindle1962">{{cite journal | vauthors = Gerzon K, Krumkalns EV, Brindle RL, Marshall FJ, Root MA | title = The adamantyl group in medicinal agents. I. Hypoglycemic N-arylsulfonyl-N'-adamantylureas | journal = J Med Chem | volume = 6 | issue = 6| pages = 760–763 | date = November 1963 | pmid = 14184942 | doi = 10.1021/jm00342a029 | url = }}</ref><ref name="Elks2014">{{cite book | vauthors = Elks J | title=The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies | publisher=Springer US | year=2014 | isbn=978-1-4757-2085-3 | url=https://books.google.com/books?id=0vXTBwAAQBAJ&pg=PA432 | access-date=2024-09-12 | page=432}}</ref> By 1972, it was discovered to have ] (CNS) activity, and was developed by ] for treatment of ]s, such as ].<ref name="AlamLingenfelterBender2017" /><ref name="Río-Sancho2020" /> Memantine was first studied in the treatment of ] in 1986.<ref name="HerrmannLiLanctôt2011" /><ref name="NRDD" /> The drug was first marketed for dementia in 1989 in Germany under the name Axura.<ref name="AlamLingenfelterBender2017" /><ref name="NRDD" /><ref name="Río-Sancho2020" />

It was not discovered to act as an ] until 1989, after clinical trials had initiated.<ref name="AlamLingenfelterBender2017" /><ref name="Río-Sancho2020" /><ref name="Bormann1989">{{cite journal | vauthors = Bormann J | title = Memantine is a potent blocker of N-methyl-D-aspartate (NMDA) receptor channels | journal = Eur J Pharmacol | volume = 166 | issue = 3 | pages = 591–592 | date = August 1989 | pmid = 2553441 | doi = 10.1016/0014-2999(89)90385-3 | url = }}</ref> Prior to this, it was theorized to directly and/or indirectly modulate the ], ], and ] systems.<ref name="Río-Sancho2020" /><ref name="ParsonsSanyszQuack1999">{{cite journal | vauthors = Parsons CG, Danysz W, Quack G | title = Memantine is a clinically well tolerated N-methyl-D-aspartate (NMDA) receptor antagonist--a review of preclinical data | journal = Neuropharmacology | volume = 38 | issue = 6 | pages = 735–767 | date = June 1999 | pmid = 10465680 | doi = 10.1016/s0028-3908(99)00019-2 | url = }}</ref><ref name="WesemannSontagMaj1983">{{cite journal | vauthors = Wesemann W, Sontag KH, Maj J | title = Pharmakodynamik und Pharmakokinetik des Memantin | trans-title = Pharmacodynamics and pharmacokinetics of memantine | language = German | journal = Arzneimittelforschung | volume = 33 | issue = 8 | pages = 1122–1134 | date = 1983 | pmid = 6357202 | doi = | url = }}</ref><ref name="JackischLinkNeufang1992">{{cite journal | vauthors = Jackisch R, Link T, Neufang B, Koch R | title = Studies on the mechanism of action of the antiparkinsonian drugs memantine and amantadine: no evidence for direct dopaminomimetic or antimuscarinic properties | journal = Arch Int Pharmacodyn Ther | volume = 320 | issue = | pages = 21–42 | date = 1992 | pmid = 1284458 | doi = | url = }}</ref> However, these actions were later realized to occur at 100-fold higher concentrations than those achieved therapeutically and hence are unlikely to be involved in its effects.<ref name="Río-Sancho2020" /><ref name="ParsonsSanyszQuack1999" /><ref name="JackischLinkNeufang1992" />

In the United States, some CNS activities were discovered at ] in 1990, and Children's licensed patents covering uses of memantine outside the field of ophthalmology to ] (NTI) in 1995.<ref name=10KSB1996>{{cite web|title=Form 10-KSB For the fiscal year ended June 30, 1996|url=https://www.sec.gov/Archives/edgar/data/918112/0000950005-96-000781.txt|publisher=SEC Edgar|date=30 September 1996|access-date=5 February 2017|archive-date=3 March 2017|archive-url=https://web.archive.org/web/20170303153629/https://www.sec.gov/Archives/edgar/data/918112/0000950005-96-000781.txt|url-status=live}} NTI-Children's license is included in the filing.</ref> In 1998, NTI amended its agreement with Children's to allow Merz to take over development.<ref name=SVBJ2000>{{cite news | vauthors = Delevett P |title=Cash is king, focus is queen |url=http://www.bizjournals.com/sanjose/stories/2000/01/10/smallb1.html |work=Silicon Valley Business Journal |date=9 January 2000 |access-date=5 February 2017 |archive-date=5 February 2017 |archive-url=https://web.archive.org/web/20170205181748/http://www.bizjournals.com/sanjose/stories/2000/01/10/smallb1.html |url-status=live }}</ref>

In 2000, Merz partnered with ] to develop the drug for Alzheimer's disease in the United States under the brand name Namenda.<ref name="AlamLingenfelterBender2017" /><ref name="NRDD">{{cite journal | vauthors = Witt A, Macdonald N, Kirkpatrick P | title = Memantine hydrochloride | journal = Nature Reviews. Drug Discovery | volume = 3 | issue = 2 | pages = 109–110 | date = February 2004 | pmid = 15040575 | doi = 10.1038/nrd1311 | s2cid = 2258982 }}</ref> In 2000, Merz partnered with Suntory for the Japanese market and with Lundbeck for other markets including Europe;<ref>{{cite web | author = Staff | work = The Pharma Letter | date = 15 August 2000 | url = http://www.thepharmaletter.com/article/lundbeck-signs-memantine-licensing-agreement-for-merz-co | title = Lundbeck signs memantine licensing agreement for Merz+Co | access-date = 6 April 2016 | archive-date = 20 April 2016 | archive-url = https://web.archive.org/web/20160420050323/http://www.thepharmaletter.com/article/lundbeck-signs-memantine-licensing-agreement-for-merz-co | url-status = live }}</ref> the drug was originally marketed by Lundbeck under the name Ebixa.<ref name=NRDD/> Memantine was approved in the ] in 2002 and in the United States in 2003.<ref name="AlamLingenfelterBender2017" /><ref name="HerrmannLiLanctôt2011" />

Sales of the drug reached $1.8 billion for 2014.<ref name="AlamLingenfelterBender2017" /><ref>{{cite web | url = https://www.drugs.com/stats/namenda | work = Drugs.com | title = Namenda Sales Data | date = February 2014 | access-date = 23 January 2018 | archive-date = 27 April 2019 | archive-url = https://web.archive.org/web/20190427171059/https://www.drugs.com/stats/namenda | url-status = live }}</ref> The cost of Namenda was $269 to $489 a month in 2012.<ref>{{cite web | url = http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/AlzheimersFINAL.pdf | work = Consumer Reports Health | title = Evaluating Prescription Drugs Used to Treat: Alzheimer's Disease. Comparing Effectiveness, Safety, and Price. | date = May 2012 | access-date = 16 February 2015 | archive-date = 5 September 2012 | archive-url = https://web.archive.org/web/20120905164340/http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/AlzheimersFINAL.pdf | url-status = live }}</ref>

In February 2014, as the July 2015 patent expiration for memantine neared, ], which had acquired Forest, announced that it was launching an extended release (XR) form of memantine that could be taken once a day instead of twice a day as needed with the then-current "immediate release" (IR) version, and that it intended to stop selling the IR version in August 2014 and withdraw the marketing authorization. This is a tactic to thwart generic competition called ]. However the supply of the XR version ran short, so Actavis extended the deadline until the fall. In September 2014 the attorney general of New York, ], filed a lawsuit to compel Actavis to keep selling the IR version on the basis of ].<ref>{{cite news | vauthors = Pollack A |title= Forest Laboratories' Namenda Is Focus of Lawsuit |url= https://www.nytimes.com/2014/09/16/business/new-york-files-antitrust-suit-against-maker-of-alzheimers-drug.html |work=The New York Times |date=15 September 2014 |access-date=24 August 2017 |archive-date=10 February 2018 |archive-url=https://web.archive.org/web/20180210074505/https://www.nytimes.com/2014/09/16/business/new-york-files-antitrust-suit-against-maker-of-alzheimers-drug.html |url-status=live }}</ref><ref name=Capati>{{cite journal | vauthors = Capati VC, Kesselheim AS | title = Drug Product Life-Cycle Management as Anticompetitive Behavior: The Case of Memantine | journal = Journal of Managed Care & Specialty Pharmacy | volume = 22 | issue = 4 | pages = 339–344 | date = April 2016 | pmid = 27023687 | doi = 10.18553/jmcp.2016.22.4.339 | pmc = 10398055 | doi-access = free }}</ref>

In December 2014, a judge granted New York State its request and issued an injunction, preventing Actavis from withdrawing the IR version until generic versions could launch. Actavis appealed and in May a panel of the ] upheld the injunction, and in June Actavis asked that its case be heard by the full Second Circuit panel.<ref>{{cite news|title=Actavis Confirms Appeals Court Ruling Requiring Continued Distribution of Namenda IR|url=https://www.allergan.com/news/news/thomson-reuters/actavis-confirms-appeals-court-ruling-requiring-co|work=Actavis|date=22 May 2015|access-date=24 August 2017|archive-date=18 November 2017|archive-url=https://web.archive.org/web/20171118173802/https://www.allergan.com/news/news/thomson-reuters/actavis-confirms-appeals-court-ruling-requiring-co|url-status=live}}</ref><ref>{{cite news| vauthors = Gurrieri V |title=Actavis, Others Plotted To Delay Generic Namenda, Suit Says |url= https://www.law360.com/articles/665234/actavis-others-plotted-to-delay-generic-namenda-suit-says |work=Law360 |date=9 June 2015 |access-date=24 August 2017|archive-date=24 August 2017|archive-url= https://web.archive.org/web/20170824134132/https://www.law360.com/articles/665234/actavis-others-plotted-to-delay-generic-namenda-suit-says |url-status=live}}</ref> In August 2015, Actavis' request was denied.<ref>{{cite news| vauthors = LoBiondo GA |title=Second Circuit Denies Petition for Actavis Rehearing {{!}} David Kleban|url=https://www.pbwt.com/david-kleban/antitrust-update-blog-2/second-circuit-denies-petition-for-actavis-rehearing/|work=Patterson Belknap Webb & Tyler LLP|date=12 August 2015|access-date=24 August 2017|archive-date=24 August 2017|archive-url=https://web.archive.org/web/20170824140007/https://www.pbwt.com/david-kleban/antitrust-update-blog-2/second-circuit-denies-petition-for-actavis-rehearing/|url-status=live}}</ref>

== Society and culture ==

=== Recreational use ===
] of memantine at supratherapeutic doses has been reported.<ref name="MorrisWallach2014">{{cite journal | vauthors = Morris H, Wallach J | title = From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs | journal = Drug Test Anal | volume = 6 | issue = 7–8 | pages = 614–632 | date = 2014 | pmid = 24678061 | doi = 10.1002/dta.1620 | url = }}</ref> It is a weak ] and is reported to produce ] and ] (PCP)-like effects in animals and humans at sufficiently high doses.<ref name="MorrisWallach2014" /><ref name="HealGosdenSmith2018">{{cite journal | vauthors = Heal DJ, Gosden J, Smith SL | title = Evaluating the abuse potential of psychedelic drugs as part of the safety pharmacology assessment for medical use in humans | journal = Neuropharmacology | volume = 142 | issue = | pages = 89–115 | date = November 2018 | pmid = 29427652 | doi = 10.1016/j.neuropharm.2018.01.049 | url = }}</ref><ref name="NicholsonJonesBalster1998">{{cite journal | vauthors = Nicholson KL, Jones HE, Balster RL | title = Evaluation of the reinforcing and discriminative stimulus properties of the low-affinity N-methyl-D-aspartate channel blocker memantine | journal = Behavioural Pharmacology | volume = 9 | issue = 3 | pages = 231–243 | date = May 1998 | pmid = 9832937 | url = https://pubmed.ncbi.nlm.nih.gov/9832937 | access-date = 1 December 2020 | url-status = live | archive-url = https://web.archive.org/web/20211016181253/https://pubmed.ncbi.nlm.nih.gov/9832937/ | archive-date = 16 October 2021 }}</ref> Even therapeutic doses have been found to produce mild dissociative-like effects in clinical studies.<ref name="MorrisWallach2014" /> In any case, the very long ] of memantine (>40{{nbsp}}hours) has likely limited its ].<ref name="MorrisWallach2014" /> Recreational use of the related drug ] has similarly been reported.<ref name="MorrisWallach2014" />

A study examining self-reported use of memantine on the social network ] showed that the drug was used both recreationally and as a ], but also that it was misused in various illnesses as ] without strong scientific basis.<ref name="NatterMichel2020">{{cite journal | vauthors = Natter J, Michel B | title = Memantine misuse and social networks: A content analysis of Internet self-reports | journal = Pharmacoepidemiology and Drug Safety | volume = 29 | issue = 9 | pages = 1189–1193 | date = September 2020 | pmid = 32602152 | doi = 10.1002/pds.5070 | s2cid = 220270495 }}</ref>

===Brand names===
As of August 2017, memantine is marketed under many brand names worldwide including Abixa, Adaxor, Admed, Akatinol, Alceba, Alios, Almenta, Alois, Alzant, Alzer, Alzia, Alzinex, Alzixa, Alzmenda, Alzmex, Axura, Biomentin, Carrier, Cogito, Cognomem, Conexine, Cordure, Dantex, Demantin, Demax, Dementa, Dementexa, Ebitex, Ebixa, Emantin, Emaxin, Esmirtal, Eutebrol, Evy, Ezemantis, Fentina, Korint, Lemix, Lindex, Lindex, Lucidex, Manotin, Mantine, Mantomed, Marbodin, Mardewel, Marixino, Maruxa, Maxiram, Melanda, Memabix, Memamed, Memando, Memantin, Memantina, Memantine, Mémantine, Memantinol, Memantyn, Memanvitae, Memanxa, Memanzaks, Memary, Memax, Memexa, Memigmin, Memikare, Memogen, Memolan, Memorel, Memorix, Memotec, Memox, Memxa, Mentikline, Mentium, Mentixa, Merandex, Merital, Mexia, Mimetix, Mirvedol, Modualz, Morysa, Namenda, Nemdatine, Nemdatine, Nemedan, Neumantine, Neuro-K, Neuroplus, Noojerone, Polmatine, Prilben, Pronervon, Ravemantine, Talentum, Timantila, Tingreks, Tonibral, Tormoro, Valcoxia, Vilimen, Vivimex, Witgen, Xapimant, Ymana, Zalatine, Zemertinex, Zenmem, Zenmen, and Zimerz.<ref name="brands">{{cite web|title=International brands for memantine|url=https://www.drugs.com/international/memantine.html|access-date=7 August 2017|publisher=Drugs.com|archive-date=25 April 2019|archive-url=https://web.archive.org/web/20190425035105/https://www.drugs.com/international/memantine.html|url-status=live}}</ref>

It is marketed in some countries as a ] with ] (]) under the brand names Namzaric, Neuroplus Dual, and Tonibral MD.<ref name="brands" />

== Research ==
=== Psychiatric disorders ===
Memantine has been studied and used ] in the treatment of a variety of ]s.<ref name="ZdanysTampi2008">{{cite journal | vauthors = Zdanys K, Tampi RR | title = A systematic review of off-label uses of memantine for psychiatric disorders | journal = Prog Neuropsychopharmacol Biol Psychiatry | volume = 32 | issue = 6 | pages = 1362–1374 | date = August 2008 | pmid = 18262702 | doi = 10.1016/j.pnpbp.2008.01.008 | url = }}</ref> These include ], ], ], ] (OCD), ], ]s (PDDs), and ] (BED).<ref name="ZdanysTampi2008" /> A 2008 ] concluded that although it was promising for such uses, memantine could not be recommended for such indications due to inadequate data.<ref name="ZdanysTampi2008" />

Memantine does not appear to be effective in the treatment of ] or ] on the basis of ]s and ], including a 2021 ].<ref name="DeanHurducasHawton2021">{{cite journal | vauthors = Dean RL, Hurducas C, Hawton K, Spyridi S, Cowen PJ, Hollingsworth S, Marquardt T, Barnes A, Smith R, McShane R, Turner EH, Cipriani A | title = Ketamine and other glutamate receptor modulators for depression in adults with unipolar major depressive disorder | journal = Cochrane Database Syst Rev | volume = 9 | issue = 9 | pages = CD011612 | date = September 2021 | pmid = 34510411 | pmc = 8434915 | doi = 10.1002/14651858.CD011612.pub3 | url = }}</ref><ref name="KleeblattBetzlerKilarski2017">{{cite journal | vauthors = Kleeblatt J, Betzler F, Kilarski LL, Bschor T, Köhler S | title = Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence | journal = Eur Neuropsychopharmacol | volume = 27 | issue = 5 | pages = 423–441 | date = May 2017 | pmid = 28318897 | doi = 10.1016/j.euroneuro.2017.03.003 | url = }}</ref><ref name="KishiMatsunagaIwata2017">{{cite journal | vauthors = Kishi T, Matsunaga S, Iwata N | title = A Meta-Analysis of Memantine for Depression | journal = J Alzheimers Dis | volume = 57 | issue = 1 | pages = 113–121 | date = 2017 | pmid = 28222534 | doi = 10.3233/JAD-161251 | url = }}</ref><ref name="VeroneseSolmiLuchini2016">{{cite journal | vauthors = Veronese N, Solmi M, Luchini C, Lu RB, Stubbs B, Zaninotto L, Correll CU | title = Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions | journal = J Affect Disord | volume = 197 | issue = | pages = 268–280 | date = June 2016 | pmid = 27010579 | doi = 10.1016/j.jad.2016.03.034 | url = https://kclpure.kcl.ac.uk/portal/en/publications/701407e1-19a7-41c7-95c0-294f8da2fdac}}</ref><ref name="BartoliCavaleriBachi2021">{{cite journal | vauthors = Bartoli F, Cavaleri D, Bachi B, Moretti F, Riboldi I, Crocamo C, Carrà G | title = Repurposed drugs as adjunctive treatments for mania and bipolar depression: A meta-review and critical appraisal of meta-analyses of randomized placebo-controlled trials | journal = Journal of Psychiatric Research | volume = 143 | pages = 230–238 | date = November 2021 | pmid = 34509090 | doi = 10.1016/j.jpsychires.2021.09.018 | s2cid = 237485915 }}</ref> However, a 2022 systematic review and meta-analysis concluded that memantine was significantly effective in the treatment of depressive symptoms in various psychiatric disorders, although with a very small ] (] = -0.17).<ref name="HsuChuChing2022">{{cite journal | vauthors = Hsu TW, Chu CS, Ching PY, Chen GW, Pan CC | title = The efficacy and tolerability of memantine for depressive symptoms in major mental diseases: A systematic review and updated meta-analysis of double-blind randomized controlled trials | journal = J Affect Disord | volume = 306 | issue = | pages = 182–189 | date = June 2022 | pmid = 35331821 | doi = 10.1016/j.jad.2022.03.047 | url = }}</ref>

There are likewise limited data to support memantine in the treatment of ] based on systematic reviews and meta-analyses.<ref name="Andrade2017">{{cite journal | vauthors = Andrade C | title = Memantine as an Augmentation Treatment for Schizophrenia: Limitations of Meta-Analysis for Evidence-Based Evaluation of Research | journal = J Clin Psychiatry | volume = 78 | issue = 9 | pages = e1307–e1309 | date = 2017 | pmid = 29178686 | doi = 10.4088/JCP.17f11998 | url = }}</ref><ref name="KishiIkutaOya2018">{{cite journal | vauthors = Kishi T, Ikuta T, Oya K, Matsunaga S, Matsuda Y, Iwata N | title = Anti-Dementia Drugs for Psychopathology and Cognitive Impairment in Schizophrenia: A Systematic Review and Meta-Analysis | journal = Int J Neuropsychopharmacol | volume = 21 | issue = 8 | pages = 748–757 | date = August 2018 | pmid = 29762677 | pmc = 6070030 | doi = 10.1093/ijnp/pyy045 | url = }}</ref> However, a 2019 systematic review and meta-analysis reported that memantine was effective in the treatment of the ] and ] of schizophrenia with medium to large effect sizes.<ref name="ZhengZhuZhang2019">{{cite journal | vauthors = Zheng W, Zhu XM, Zhang QE, Cai DB, Yang XH, Zhou YL, Ungvari GS, Ng CH, He SH, Peng XJ, Ning YP, Xiang YT | title = Adjunctive memantine for major mental disorders: A systematic review and meta-analysis of randomized double-blind controlled trials | journal = Schizophr Res | volume = 209 | issue = | pages = 12–21 | date = July 2019 | pmid = 31164254 | doi = 10.1016/j.schres.2019.05.019 | url = }}</ref>

=== Parkinson's disease ===
Memantine has been studied in the treatment of ] since the early 1970s.<ref name="HerrmannLiLanctôt2011" /><ref name="Río-Sancho2020" /><ref name="LangeRiederer1994" /><ref name="FischerJacobiSchneider1977">{{cite journal | vauthors = Fischer PA, Jacobi P, Schneider E, Schönberger B | title = Die Wirkung intravenöser Gaben von Memantin bei Parkinson-Kranken | trans-title = Effects of intravenous administration of memantine in parkinsonian patients | language = German | journal = Arzneimittelforschung | volume = 27 | issue = 7 | pages = 1487–1489 | date = July 1977 | pmid = 332193 | doi = | url = }}</ref><ref name="SchneiderFischerClemens1984">{{cite journal | vauthors = Schneider E, Fischer PA, Clemens R, Balzereit F, Fünfgeld EW, Haase HJ | title = | language = German | journal = Dtsch Med Wochenschr | volume = 109 | issue = 25 | pages = 987–990 | date = June 1984 | pmid = 6734455 | doi = 10.1055/s-2008-1069311 | url = }}</ref> Whereas the related drug ] is approved for the treatment of Parkinson's disease and has been since the early 1970s,<ref name="DanyszDekundyScheschonka2021" /> memantine is not approved for the treatment of Parkinson's disease as of 2024.<ref name="AdisInsight">{{cite web | title=Memantine - Children's Medical Center Corporation/Merz Pharma | website=AdisInsight | date=5 November 2023 | url=https://adisinsight.springer.com/drugs/800006923 | access-date=12 September 2024}}</ref> However, it has been said that memantine, along with amantadine, has been widely used as an ] since at least 1994.<ref name="LangeRiederer1994">{{cite journal | vauthors = Lange KW, Riederer P | title = Glutamatergic drugs in Parkinson's disease | journal = Life Sci | volume = 55 | issue = 25–26 | pages = 2067–2075 | date = 1994 | pmid = 7997066 | doi = 10.1016/0024-3205(94)00387-4 | url = https://epub.uni-regensburg.de/25418/1/langekw5.pdf}}</ref>

Although amantadine and memantine have fairly similar ], it has been said that memantine does not share the ] effects of amantadine.<ref name="OlivaresDeshpandeShi2012">{{cite journal | vauthors = Olivares D, Deshpande VK, Shi Y, Lahiri DK, Greig NH, Rogers JT, Huang X | title = N-methyl D-aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer's disease, vascular dementia and Parkinson's disease | journal = Curr Alzheimer Res | volume = 9 | issue = 6 | pages = 746–758 | date = July 2012 | pmid = 21875407 | pmc = 5002349 | doi = 10.2174/156720512801322564 | url = }}</ref><ref name="MerelloNouzeillesCammarota1999" /> However, findings are conflicting, and some data suggest that memantine may also have antidyskinetic effects.<ref name="Gonzalez-LatapiGhomwickSaranza2020">{{cite journal | vauthors = Gonzalez-Latapi P, Bhowmick SS, Saranza G, Fox SH | title = Non-Dopaminergic Treatments for Motor Control in Parkinson's Disease: An Update | journal = CNS Drugs | volume = 34 | issue = 10 | pages = 1025–1044 | date = October 2020 | pmid = 32785890 | doi = 10.1007/s40263-020-00754-0 | url = }}</ref><ref name="Onofrj_2016">{{cite book | vauthors = Onofrj M, Frazzini V, Bonanni L, Thomas A | chapter = Chapter 3 - Amantadine and antiglutamatergic drugs in the management of Parkinson's disease | veditors = Gálvez-Jiménez N, Fernandez HH, Espay AJ, Fox SH | title=Parkinson's Disease: Current and Future Therapeutics and Clinical Trials | publisher=Cambridge University Press | series=Cambridge medicine | year=2016 | isbn=978-1-107-05386-1 | chapter-url=https://books.google.com/books?id=hGOSCwAAQBAJ&pg=PA16 | access-date=12 September 2024 | page=16}}</ref><ref name="VidalFukushimaValle2013">{{cite journal | vauthors = Vidal EI, Fukushima FB, Valle AP, Villas Boas PJ | title = Unexpected improvement in levodopa-induced dyskinesia and on-off phenomena after introduction of memantine for treatment of Parkinson's disease dementia | journal = J Am Geriatr Soc | volume = 61 | issue = 1 | pages = 170–172 | date = January 2013 | pmid = 23311565 | doi = 10.1111/jgs.12058 | url = }}</ref> Similarly to amantadine and ]s, memantine reverses ]-induced ] and ]-induced ] in animals.<ref name="OlivaresDeshpandeShi2012" /><ref name="DanyszGosselSajaczkowski1994">{{cite journal | vauthors = Danysz W, Gossel M, Zajaczkowski W, Dill D, Quack G | title = Are NMDA antagonistic properties relevant for antiparkinsonian-like activity in rats?--case of amantadine and memantine | journal = J Neural Transm Park Dis Dement Sect | volume = 7 | issue = 3 | pages = 155–166 | date = 1994 | pmid = 7710668 | doi = 10.1007/BF02253435 | url = }}</ref> Memantine has been found to reduce ] and ] in people with Parkinson's disease.<ref name="OlivaresDeshpandeShi2012" /><ref name="MerelloNouzeillesCammarota1999">{{cite journal | vauthors = Merello M, Nouzeilles MI, Cammarota A, Leiguarda R | title = Effect of memantine (NMDA antagonist) on Parkinson's disease: a double-blind crossover randomized study | journal = Clin Neuropharmacol | volume = 22 | issue = 5 | pages = 273–276 | date = 1999 | pmid = 10516877 | doi = | url = }}</ref> Memantine and amantadine are said to have moderate ] effects in the treatment of Parkinson's disease.<ref name="LangeRiederer1994" /><ref name="RabeyNissipeanuKorczyn1992">{{cite journal | vauthors = Rabey JM, Nissipeanu P, Korczyn AD | title = Efficacy of memantine, an NMDA receptor antagonist, in the treatment of Parkinson's disease | journal = J Neural Transm Park Dis Dement Sect | volume = 4 | issue = 4| pages = 277–282 | date = 1992 | pmid = 1388698 | doi = 10.1007/BF02260076 | url = }}</ref> The doses of memantine used for Parkinson's disease are about 5- to 10-fold lower than those of amantadine, which has been attributed to greater ] of memantine.<ref name="LangeRiederer1994" />

As of 2022, a ] ] is studying the potential of memantine as ] for Parkinson's disease that might slow progression of the disease.<ref name="GrossoJasutkarOh2022">{{cite journal | vauthors = Grosso Jasutkar H, Oh SE, Mouradian MM | title = Therapeutics in the Pipeline Targeting α-Synuclein for Parkinson's Disease | journal = Pharmacol Rev | volume = 74 | issue = 1 | pages = 207–237 | date = January 2022 | pmid = 35017177 | pmc = 11034868 | doi = 10.1124/pharmrev.120.000133 | url = }}</ref><ref name="McFarthingRafaloffBaptista2022">{{cite journal | vauthors = McFarthing K, Rafaloff G, Baptista M, Mursaleen L, Fuest R, Wyse RK, Stott SR | title = Parkinson's Disease Drug Therapies in the Clinical Trial Pipeline: 2022 Update | journal = Journal of Parkinson's Disease | volume = 12 | issue = 4 | pages = 1073–1082 | date = 2022 | pmid = 35527571 | pmc = 9198738 | doi = 10.3233/JPD-229002 }}</ref><ref name="NCT03858270">{{ClinicalTrialsGov|NCT03858270|Inhibition of α-synuclein Cell-cell Transmission by NMDAR Blocker, Memantine}}</ref> It is specifically theorized to act by inhibiting cell-to-cell transmission of ].<ref name="GrossoJasutkarOh2022" /><ref name="McFarthingRafaloffBaptista2022" />

Besides Parkinson's disease, memantine has been studied in the treatment of ] (PDD) and ] (DLB).<ref name="BallardKahnCorbett2011">{{cite journal | vauthors = Ballard C, Kahn Z, Corbett A | title = Treatment of dementia with Lewy bodies and Parkinson's disease dementia | journal = Drugs Aging | volume = 28 | issue = 10 | pages = 769–777 | date = October 2011 | pmid = 21970305 | doi = 10.2165/11594110-000000000-00000 | url = }}</ref><ref name="SzetoLewis2016">{{cite journal | vauthors = Szeto JY, Lewis SJ | title = Current Treatment Options for Alzheimer's Disease and Parkinson's Disease Dementia | journal = Curr Neuropharmacol | volume = 14 | issue = 4 | pages = 326–338 | date = 2016 | pmid = 26644155 | pmc = 4876589 | doi = 10.2174/1570159x14666151208112754 | url = }}</ref><ref name="WangYuTang2015">{{cite journal | vauthors = Wang HF, Yu JT, Tang SW, Jiang T, Tan CC, Meng XF, Wang C, Tan MS, Tan L | title = Efficacy and safety of cholinesterase inhibitors and memantine in cognitive impairment in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies: systematic review with meta-analysis and trial sequential analysis | journal = J Neurol Neurosurg Psychiatry | volume = 86 | issue = 2 | pages = 135–143 | date = February 2015 | pmid = 24828899 | doi = 10.1136/jnnp-2014-307659 | url = }}</ref>

=== Apathy ===
Apathy is a ] characterized by diminished interest and activity.<ref name="MarinWilkosz2005">{{cite journal | vauthors = Marin RS, Wilkosz PA | title = Disorders of diminished motivation | journal = J Head Trauma Rehabil | volume = 20 | issue = 4 | pages = 377–388 | date = 2005 | pmid = 16030444 | doi = 10.1097/00001199-200507000-00009 | url = }}</ref><ref name="ChongHusain2016">{{cite book | vauthors = Chong TT, Husain M | chapter = The role of dopamine in the pathophysiology and treatment of apathy | title = Motivation - Theory, Neurobiology and Applications | journal = Prog Brain Res | series = Progress in Brain Research | volume = 229 | issue = | pages = 389–426 | date = 2016 | pmid = 27926449 | doi = 10.1016/bs.pbr.2016.05.007 | isbn = 978-0-444-63701-7 | url = }}</ref> ]s and ] published from 2016 to 2022 have found that memantine is not effective in the treatment of ] in Alzheimer's disease and other ]s.<ref name="SepehrySaraiHsiung2017">{{cite journal | vauthors = Sepehry AA, Sarai M, Hsiung GR | title = Pharmacological Therapy for Apathy in Alzheimer's Disease: A Systematic Review and Meta-Analysis | journal = Can J Neurol Sci | volume = 44 | issue = 3 | pages = 267–275 | date = May 2017 | pmid = 28148339 | doi = 10.1017/cjn.2016.426 | url = }}</ref><ref name="HarrisonAertsBrodaty2016">{{cite journal | vauthors = Harrison F, Aerts L, Brodaty H | title = Apathy in Dementia: Systematic Review of Recent Evidence on Pharmacological Treatments | journal = Curr Psychiatry Rep | volume = 18 | issue = 11 | pages = 103 | date = November 2016 | pmid = 27726067 | doi = 10.1007/s11920-016-0737-7 | url = }}</ref><ref name="Andrade2022">{{cite journal | vauthors = Andrade C | title = Methylphenidate and Other Pharmacologic Treatments for Apathy in Alzheimer's Disease | journal = J Clin Psychiatry | volume = 83 | issue = 1 | pages = | date = February 2022 | pmid = 35120284 | doi = 10.4088/JCP.22f14398 | url = }}</ref> However, another 2022 review reported that it was effective.<ref name="AzharKusumoMarotta2022">{{cite journal | vauthors = Azhar L, Kusumo RW, Marotta G, Lanctôt KL, Herrmann N | title = Pharmacological Management of Apathy in Dementia | journal = CNS Drugs | volume = 36 | issue = 2 | pages = 143–165 | date = February 2022 | pmid = 35006557 | doi = 10.1007/s40263-021-00883-0 | url = }}</ref>

=== Long COVID ===
Memantine, along with ], is being studied and used ] in the treatment ].<ref name="MüllerRiedererKuhn2023">{{cite journal | vauthors = Müller T, Riederer P, Kuhn W | title = Aminoadamantanes: from treatment of Parkinson's and Alzheimer's disease to symptom amelioration of long COVID-19 syndrome? | journal = Expert Rev Clin Pharmacol | volume = 16 | issue = 2 | pages = 101–107 | date = February 2023 | pmid = 36726198 | doi = 10.1080/17512433.2023.2176301 | url = }}</ref><ref name="FronteraGuekhtAllegri2023">{{cite journal | vauthors = Frontera JA, Guekht A, Allegri RF, Ashraf M, Baykan B, Crivelli L, Easton A, Garcia-Azorin D, Helbok R, Joshi J, Koehn J, Koralnik I, Netravathi M, Michael B, Nilo A, Özge A, Padda K, Pellitteri G, Prasad K, Romozzi M, Saylor D, Seed A, Thakur K, Uluduz D, Vogrig A, Welte TM, Westenberg E, Zhuravlev D, Zinchuk M, Winkler AS | title = Evaluation and treatment approaches for neurological post-acute sequelae of COVID-19: A consensus statement and scoping review from the global COVID-19 neuro research coalition | journal = J Neurol Sci | volume = 454 | issue = | pages = 120827 | date = November 2023 | pmid = 37856998 | doi = 10.1016/j.jns.2023.120827 | url = }}</ref>

=== Catatonia ===
Memantine, along with ], has been reported to be effective in the treatment of ] in ]s and ].<ref name="BeachGomez-BernalHuffman2017">{{cite journal | vauthors = Beach SR, Gomez-Bernal F, Huffman JC, Fricchione GL | title = Alternative treatment strategies for catatonia: A systematic review | journal = Gen Hosp Psychiatry | volume = 48 | issue = | pages = 1–19 | date = September 2017 | pmid = 28917389 | doi = 10.1016/j.genhosppsych.2017.06.011 | url = }}</ref><ref name="ObregonVelascoWuerz2011">{{cite journal | vauthors = Obregon DF, Velasco RM, Wuerz TP, Catalano MC, Catalano G, Kahn D | title = Memantine and catatonia: a case report and literature review | journal = J Psychiatr Pract | volume = 17 | issue = 4 | pages = 292–299 | date = July 2011 | pmid = 21775832 | doi = 10.1097/01.pra.0000400268.60537.5e | url = }}</ref><ref name="GrazianeDavidowiczFrancis2020">{{cite journal | vauthors = Graziane J, Davidowicz E, Francis A | title = Can Memantine Improve Catatonia and Co-occurring Cognitive Dysfunction? A Case Report and Brief Literature Review | journal = Psychosomatics | volume = 61 | issue = 6 | pages = 759–763 | date = 2020 | pmid = 32665151 | doi = 10.1016/j.psym.2020.05.026 | url = }}</ref>

=== Autism ===
Effects in ] are unclear.<ref name="Parr2010">{{cite journal | vauthors = Parr J | title = Autism | journal = BMJ Clinical Evidence | volume = 2010 | date = January 2010 | pmid = 21729335 | pmc = 2907623 }}</ref><ref name="Hong Erickson 2019 pp. 709–718">{{cite journal | vauthors = Hong MP, Erickson CA | title = Investigational drugs in early-stage clinical trials for autism spectrum disorder | journal = Expert Opinion on Investigational Drugs | volume = 28 | issue = 8 | pages = 709–718 | date = August 2019 | pmid = 31352835 | doi = 10.1080/13543784.2019.1649656 | publisher = Informa UK Limited | s2cid = 198967266 }}</ref>

== References ==
{{Reflist}}

== Further reading ==
{{refbegin}}
* {{cite journal | vauthors = Lipton SA | title = The molecular basis of memantine action in Alzheimer's disease and other neurologic disorders: low-affinity, uncompetitive antagonism | journal = Current Alzheimer Research | volume = 2 | issue = 2 | pages = 155–165 | date = April 2005 | pmid = 15974913 | doi = 10.2174/1567205053585846 }}
{{refend}}

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