Sammendrag
The elderly population of Norway is surging, and so is the use of medication for Alzheimer dementia. This paper seeks to investigate the validity of prescription guidelines as compared to current evidence regarding the novel drug memantine. Memantine is an expensive drug of modest effect, prescribed for moderate-to-severe Alzheimer dementia. Two meta-analyses supply the evidence: The well known Cochrane study of 2006 and the Lundbeck study of 2007. Lundbeck is the producer of Ebixa, Norway’s sole source of memantine. In this paper, both studies have their quality examined and the validity of prescription guidelines, memantine for moderate-to-severe Alzheimer dementia, are commented in light of the evidence gathered. Results: Both studies show slight, but clinically evident and significant effect on global and cognitive domains. Limitations: The Cochrane study comes out methodologically superior to the Lundbeck-study; the latter lacking as to the risk of bias. The studies are limited to a six-month duration and economical effects are unconfirmed. They differ somewhat on their definition of moderate-to-serious dementia. Implications for further research: Concomitant use with donepezil and effect on agitation may show promise and impact on family-burden is still unexplored, as is the effect on specific symtoms. Conclusion: Treatment of Alzheimers disease with memantine causes a marginal, but significant improvement in the domains of cognition and global assessment of dementia, confirming the validity of current prescription guidelines. This effect may not be evident to the clinician.