Memantine Plus Es-citalopram in Elderly Depressed Patients With Cognitive Impairment
Status:
Completed
Trial end date:
2010-03-01
Target enrollment:
Participant gender:
Summary
Alzheimer's disease (AD), the most common dementing disorder of later life, is a major cause
of disability and death in the elderly. Although a number of theoretical causes exist, the
etiology of AD is still unknown. Consequently, the focus of treatments has been palliative,
designed to ameliorate AD symptoms. Recent efforts, however, have revealed some surprising
data suggesting that cholinesterase inhibitors (AchEIs), used over the last decade, and
recently released memantine (an N-methyl-D-aspartate (NMDA) receptor antagonist), may confer
protection to neurons. Thus, they may offer a slowing of cognitive decline and/or improvement
in behavioral symptoms associated with memory impairment.
Over the last decade, it has been well documented that mild cognitive impairment (MCI)
increases the risk of conversion to AD and that coincident depression and MCI (Dep-MCI)
further increases the risk 2 to 3 fold. The primary focus of this line of investigation is to
treat the very high risk to dement patient population with Dep-MCI, before they develop AD,
in the hopes of delaying AD onset.
Memantine had not been studied in DEP-MCI patients. Since treatment of these patients with
combined antidepressant and AChEIs has been associated with cognitive improvement in pilot
studies, we explore whether treatment of DEP-MCI with memantine in addition to antidepressant
treatment would benefit cognitive performance and lead to a low rate of conversion to
dementia. We evaluate the cognitive and antidepressant benefit of combined open-label
es-citalopram and memantine treatment over 48 weeks in a DEP-CI sample.