FPIN's Help Desk Answers
Alzheimer Disease: Monotherapy vs. Combination Therapy
Am Fam Physician. 2017 Apr 1;95(7):452.
Is the combination of memantine with donepezil more effective in the treatment of Alzheimer disease than either drug alone?
Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease. (Strength of Recommendation: B, based on a meta-analysis of randomized controlled trials.)
A meta-analysis of three double-blind randomized controlled trials evaluated the use of combination therapy with memantine plus donepezil (two studies) or memantine plus donepezil, galantamine, or rivastigmine in patients with Alzheimer disease.1 Data were analyzed for 1,043 patients
1. Muayqil T, et al. Systematic review and meta-analysis of combination therapy with cholinesterase inhibitors and memantine in Alzheimer's disease and other dementias. Dement Geriatr Cogn Dis Extra. 2012;2(1):546–572.
2. Gareri P, et al. Retrospective study on the benefits of combined Memantine and cholinEsterase inhibitor treatMent in AGEd Patients affected with Alzheimer's disease. J Alzheimers Dis. 2014;41(2):633–640.
Help Desk Answers provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (http://www.cebm.net/?o=1025).
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