THERAPEUTICS

Brands

• Namenda
• see index for additional brand names

Generic?

• No

Class

• NMDA receptor antagonist; N-methyl-d-aspartate (NMDA) subtype of glutamate receptor antagonist; cognitive enhancer

Commonly Prescribed For

• (bold for FDA approved)
• Alzheimer disease (moderate to severe)
• Alzheimer disease (mild to moderate)
• Memory disorders in other conditions
• Mild cognitive impairment
• Chronic pain

How The Drug Works

• Is a low to moderate affinity noncompetitive (open-channel) NMDA receptor antagonist, which binds preferentially to the NMDA receptor-operated cation channels
• Presumably interferes with the postulated persistent activation of NMDA receptors by excessive glutamate release in Alzheimer disease

How Long Until It Works

• Memory improvement is not expected and it may take months before any stabilization in degenerative course is evident

If It Works

• May slow progression of disease, but does not reverse the degenerative process

If It Doesn’t Work

• Consider adjusting dose, switching to a cholinesterase inhibitor or adding a cholinesterase inhibitor
• Reconsider diagnosis and rule out other conditions such as depression or a dementia other than Alzheimer disease

Best Augmenting Combos for Partial Response or Treatment-Resistance

• Atypical antipsychotics to reduce behavioral disturbances
• Antidepressants if concomitant depression, apathy, or lack of interest
• May be combined with cholinesterase inhibitors
• Divalproex, carbamazepine, or oxcarbazepine for behavioral disturbances

Tests

• None for healthy individuals