Non-competitive NMDA receptor antagonist
ATC code: N06DX01 (Memantine)
Brand names
Ebixa, Axura, Namenda, Memary
A low-affinity non-competitive NMDA glutamate receptor antagonist. In Alzheimer's disease, chronic excess glutamate release leads to excitotoxicity and neuronal loss. Memantine blocks pathological NMDA receptor activation while preserving physiological function. Does not affect cholinergic system – safely combined with acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine). Half-life 60–80 hours.
First line
Drug of choice in moderate-to-severe Alzheimer's disease per 2018, 2024, and the Spanish SEN 2024 consensus. Dose titrated from 5 mg once daily to 20 mg (5 mg per week). Effect is modest – slows cognitive decline by about 6 months and improves daily functioning, without modifying the underlying disease. Often combined with donepezil in moderate-to-severe disease.
Approved for moderate-to-severe Alzheimer's disease (MMSE 3–14).
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Memantine is an NMDA receptor antagonist. It is prescribed for moderate-to-severe Alzheimer's disease ( 2018 and NG97 guidelines; the Cochrane review by McShane 2019 confirms benefit only at these stages). For healthy adults as a nootropic or memory enhancer, memantine does not work: clinical studies in people without dementia have not shown improvement in cognitive function. The drug has specific risks: dizziness, confusion, elevated blood pressure, and headache. If memantine was recommended to a healthy person for memory, consider seeking a second opinion.
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No data in pregnancy. Not indicated – Alzheimer's in women of reproductive age is exceedingly rare.
No data. Not used during lactation.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Memantine is evaluated for the following indications with varying evidence strength: Alzheimer disease (evidence tier A), Memory and concentration enhancement (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Memantine (≥ 1 in 100): Dizziness, Headache, Drowsiness, Constipation, Hypertension, Dyspnea. See the Safety section for uncommon and serious reactions.
FDA category B. No data in pregnancy. Not indicated – Alzheimer's in women of reproductive age is exceedingly rare.
No data. Not used during lactation.
Memantine is contraindicated in: Memantine hypersensitivity; Severe renal impairment (eGFR under 30); Pregnancy and lactation; Age under 18. Full list in the Safety section.