Memantine: What It Does, How to Use It, and What to Watch For

Memantine is a prescription medicine used to treat moderate to severe Alzheimer's disease symptoms. It won't cure dementia, but it can help with thinking, memory, and daily function for some people. Many caregivers notice small but meaningful changes when memantine is added to treatment.

Doctors usually give memantine when cholinesterase inhibitors alone aren't enough or for later-stage care. It's sometimes combined with drugs like donepezil. The goal is better clarity for daily tasks and fewer episodes of confusion or agitation.

How memantine works

Memantine acts on glutamate pathways in the brain by blocking NMDA receptors. Too much glutamate can overstimulate brain cells and cause damage. By gently limiting that overactivity, memantine may protect cells and help the brain communicate more clearly.

Because it targets a different system than cholinesterase inhibitors, memantine can be used alongside them. That complementary approach may offer a modest extra benefit compared with either drug alone.

Typical starting dose is low and increased over weeks to a maintenance dose often 10 mg twice daily for adults. Your doctor will give a clear schedule. For people with kidney problems, lower doses or slower increases may be needed.

Common side effects include dizziness, headache, constipation, and confusion. Some people feel tired or have mild hallucinations. Most side effects are mild and appear early; if they continue or get worse, call your healthcare provider.

Practical tips and safety

Take memantine exactly as prescribed, at the same times each day. You can take it with or without food. Don't stop suddenly — your doctor may want to taper the dose. Keep a list of all medicines, vitamins, and supplements to check for interactions.

Strong drugs that change urine pH or compete for kidney clearance can affect memantine levels. Tell your doctor about diuretics, antacids, and some heart or psychiatric medicines. If you have severe kidney disease, discuss dose changes first.

Watch for new or worsening confusion, balance problems, or behavior shifts. Those may come from the medicine, the illness, or another condition. Regular follow-up visits help your clinician decide if memantine is helping and if the dose should change.

Who shouldn't take memantine? People with known hypersensitivity to the drug should avoid it. Pregnant or breastfeeding people generally won't use it unless a doctor advises otherwise. For older adults, cautious dosing and close monitoring are common.

Quick FAQ: How fast does it work? Some notice change in a few weeks; others need months. Can it be combined with other dementia drugs? Yes, often with cholinesterase inhibitors. Is memory restored? No—memantine may slow decline or improve function, not reverse disease.

If you're caring for someone with dementia, ask their clinician about memantine's risks and benefits for that person's situation. Small improvements can matter a lot when they help with daily routines and reduce stress for both the person and caregiver.

Keep a medication list, record side effects, and bring notes to appointments to get the most from memantine therapy.