Memantine

Stan2

My DW's neurologist increased her donepizil dosage from 5mg to 10 mg and she was experiencing nausea. We reduced the dosage back to 5mg and the nausea stopped. The neurologist has now prescribed 5mg memantine twice a day to supplement the 5mg donepizil. Do any of you have experience with memantine and possible side effects?

​fesk

Hi Stan2,

Everyone will react differently to the medication. My mother took both Aricept and Namenda for years with no issue. Namenda may cause lethargy and dizziness, but each person will be different. I recommend watching for any side of these side effects and giving extra assistance or being mindful when your wife is getting up from a seated position or walking if she is still doing those things. If there are side effects, it may need a period of adjustment.

I hope she is able to tolerate the medicine and it is helpful.

annie51

My DH has been on Memantine 10 mg twice/day for several years now with no side effects. They started with 5 mg to see if he could tolerate it, then moved up. But he does not take Donepezil.

Stan2

https://alzconnected.org/discussion/comment/214367#Comment_214367

Thank you

Stan2

Thank you.

Belle60

My DH has been on both meds for about 4 years now without any side effects. Not sure how much it has helped but I like to believe it has slowed progression.

Elizabeth607

My DH has been on both since October 2023. He does not appear to have any side effects.

Stan2

https://alzconnected.org/discussion/comment/214471#Comment_214471

https://alzconnected.org/discussion/comment/214471#Comment_214471

Thank you.

Despondent

My DH was started on Donepezil 5mg. 3yrs. ago. Our PCP did so reluctantly. He didn't believe these drugs worked. Well in about 3 days, I started to see a marked improvement in his memory and cognitive abilities. Because the PCP never prescribed the pills, he increased the dose to10mg in a week. 10mg is a typical maintenance dose but is not to be increased until 1 month after started taking the pills. My husband immediately started having headaches and an upset stomach. I took him to Urgent Care to have him checked out. Nothing showed on any bloodwork. I did not tell them about recent increase in dosage because I didn't want that to influence any diagnosis. I called our PCP told him about my husband's side effect and said, he was good on 5mg., I'm dropping back to the 5. Saw neurologist for the 1st time 6 mos. later he added memantine 10 mg 2X daily which seemed to help with no side effects. About a year ago I saw a decrease in my husband's cognitive abilities and memories. I told neurologist, he suggested we increase the donepezil to 10mg, since it had been almost 3 yr. since he had started the 5mg. Sounded reasonable. Again, I saw a remarkable increase in his thinking and was happy until…About 2 weeks after he had a psychotic break. He left the house. I thought he was outside working. Neighbors called me and said they were leaving the small town and saw him walking out to the main highway. They offered him a lift but he wasn't willing and seemed upset. I went after him. By then he had crossed the 4 lanes of traffic (with traffic light). I tried to approach him to ask him to get in the van and we would go home and talk. But being a long light and I had to wait for the changes, it took awhile to try and get to him because he kept crossing the road. At one point, he was on the opposite side. I had to drive a distance past him and make a U-turn. I no longer saw him. I assumed he had cut through someone's back yard. I thought this is crazy so I called 911. I was on the side of the road with my 4 ways on. Local police pulled up and asked if I had car trouble. I said no and started to explain about calling 911. He stopped me because the message was just coming through his radio. He then said, yes I saw this guy walking but then I didn't see him. We both thought he had walked through yards to side road that led back through the town. So he left and caught up with my husband where we guessed he might be. I knew my husband wanted nothing to do with me but the officer said he wouldn't get in his car and didn't remember his address. So I stayed behind my husband driving with my 4 ways while he walked home. We didn't talk for several hours, I didn't know how to approach him but I'm getting better but still need to learn a lot more. He later told me he was planning on running out in front of a truck to hit him. I said, that doesn't always end things, you could have been left paralyzed and think about the driver who would have hit you and how he would have felt. At that point he was still able to grasp that meaning. Medications are no longer working but he is seeing a psychiatrist who is managing other meds, an anti-depressant and possibly something else if needed. So these drugs do work but you still need to be mindful of side effects if there is a change in dosage.

tigersmom

@Stan2, DH was put on donepezil at diagnosis three years ago and has remained on it to no ill effect. Memantine was started three months later, while he was still in stage four. By the time I got it titrated up to full dose, he was a raging, angry person who yelled at customer service agents over the phone. With his neurologist’s blessing, I stopped it. iMHO, these meds don’t do as much as the antidepressants and now the anti psychotics we need three years later.

l7pla1w2

I'm jealous of your early success. DW has been on donepezil 23mg and memantine 10mg x 2 for quite some time now. I never saw any improvement, and it's impossible to know whether the meds delayed her decline.

Tlf44

https://alzconnected.org/discussion/69735/memantine

My wife has been on 10 mg of each donepizil and memantine twice a day for 3 years without any problems . She sleeps more with this dosage . She is at stage 5 Alzheimers . God Bless us all.

Stan2

https://alzconnected.org/discussion/comment/214480#Comment_214480

Thank You

Stan2

Thank you all for your comments and sharing your experiences. I truly appreciate your input.

Stan2

An update. We started DW on 5mg memantine just at night to see how she would handle it. She seemed to tolerate it well with no adverse effects and I believe I did see some cognitive improvement. She just seemed like she was more aware and more in tune with her surroundings. With such good results we decided to start her on 5mg twice a day as prescribed.

Yesterday was her first day of the full dosage. She got up on her own about 7:30 am , said she had slept well and was feeling good. She took her morning meds and sat in her chair to watch tv. About 9:30 am she said she was really tired and wanted to go back to bed. She did so and slept until about 3pm when I thought I should wake her. When she awakened she had tremors far more pronounced than ever before. She could not get up by herself to use the restroom or to dress herself. Never before had she had a problem with that. She did stay awake the rest of the day and regained some strength but she was not herself. I decided I would not give her the memantine dosage this morning and she has been fine today. I think we'll hold off another week and then try the morning dosage one more time.

​fesk

Hi Stan,

I am sorry to hear that happened. Namenda can definitely make someone lethargic. It could be something that she would adjust to or perhaps she will not. She may also not be able to take it in the morning - only at night (that is what we did I believe). If the 5mg once a day is having a positive effect, you may want to leave it there for quite some time. My mother's first doctor was very slow to add or increase meds. We didn't add Namenda to Aricept until we saw a decline. I believe we were then slow to increase Namenda. There is something to be said for the medicine reaching an effective dose but that may differ with each person.

I hope you find a beneficial amount without side effects.

Keep us posted.

Crkddy

DW has been on memantine 10mg twice a day and donepezil 23mg at bedtime for about 5 years. It may be my imagination, but I believe these meds are making more of a difference now than they did early on. They are both advertised as designed for moderate-to-severe dementia. I have twice tried to wean DW off these meds at the direction of one of her previous neurologists and a previous hospice doctor. Both times I noticed an immediate negative decline, so I restarted both meds. Every case is different and experiences documented on this site describe a variety of different reactions to these meds and others. You are doing the best you can do by monitoring how you DW responds to these meds and adjusting accordingly. Continue to work with your doctors to find the right combinations, and be prepared to change as your DW progresses.

HollyBerry

My partner has been on both for several years. The provider in memory clinic increased the memantine to 15 mg last month, right before a visit from my family that I had been really excited about, but was also worried that she would have trouble with guests in the house. She did AWESOME every day but one. Whether it was the increased dose or my attitude (I was determined to make this a good visit and had really thought through some ways to promote success), I was thrilled with how well she did.

She takes Donepezil at night and memantine in the morning, which I guess is opposite what most people do. The donepezil is a downer for her and when we mixed them up by accident, she was groggy and dull during the day. She also takes antidepressants in the am and all these drugs work in concert with each other.