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Review backs memantine

Memantine is clinically effective in patients with moderate to severe Alzheimer's disease, a gold standard Cochrane review finds.

The review will add to the controversy over provision of Alzheimer's drugs, after a draft appraisal from NICE found it was not a cost-effective therapy.

The institute provisionally ruled that memantine should only be used in Alzheimer's patients as part of a clinical study.

But the Cochrane review, published on the foundation's website this week, found that memantine at 20mg a day produced a clinically noticeable reduction in deterioration over 28 weeks compared with placebo in patients with moderate to severe Alzheimer's disease.

The authors concluded the drug had a 'small beneficial effect' at six months.

Study leader Dr Rupert McShane, honorary consultant in old age psychiatry at the University of Oxford, said memantine did seem to offer 'a little help'

to advanced dementia patients.

'It is useful for relatives and carers to know this so they can make their own decisions about taking it,' he said.

He added: 'NICE did its own analysis and came to its own conclusions. I don't agree with all its decisions, but there's no getting away from the fact that the overall effect is small.

'But what's more interesting is that memantine might help to prevent agitation, which is a big clinical problem.'

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