![]() ![]() Memantine is commonly associated with confusion, dizziness, and headache. Memantine does not inhibit acetylcholinesterase, thus it has a lower prevalence of cholinomimetic tolerability issues such as nausea, vomiting, and diarrhea. Guideline Watch (October 2014): Practice Guideline for the Treatment of Patients With Alzheimer's Disease and Other Dementias. Rabins P, Rovner B, Rummans T, Schneider L, Tariot P. ![]() Cranbury, NJ: Sun Pharmaceutical Industried Ltd 2016 ![]() Memantine can be used with acetylcholinesterase Inhibitors and would be an appropriate supplementation to rivastigmine as the patient’s cognitive function continues to decline. The maximum dose of rivastigmine is 12 mg/day orally making 8 mg BID inappropriate. Donepezil is in the same class of rivastigmine and would increase the risk of side effects. Decreasing her dose to 3 mg BID with signs of worsening cognition and the absence of side effects would not be appropriate. Because the patient’s MMSE score is lower her dementia is worsening. Mini Mental Status Examination (MMSE) has three categories for dementia: a score of 20-24 is mild dementia, 13-20 is moderate dementia, and less than 12 is severe dementia. ![]()
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