Question: In patients with Alzheimer’s dementia, how effective is memantine compared to either cholinesterase inhibitors or placebo in reducing anxiety and psychotic symptoms?

Answer:

There was some, very limited evidence that treatment with memantine (in addition to acetylcholinesterase inhibitors) may have a short term (6-12 weeks) beneficial effect on psychotic symptoms (delusions and hallucinations), in patients with moderate to severe Alzheimer's disease, compared to treatment with acetylcholinesterase inhibitors alone. However, it was not clear whether this effect was maintained in the longer term (results were inconsistent at 24 weeks). No study showed any significant effect of memantine on anxiety symptoms. No studies were identified which compared treatment with memantine alone to treatment with acetylcholinesterase inhibitors alone.

Larger, high quality RCTs are needed to fully assess the effects of memantine on anxiety and psychotic symptoms in patients with Alzheimer's disease.