To Treat Alzheimer Disease, Two Drugs May Be Better Than One

Patients, families, and clinicians eager to delay or reverse cognitive and related impairments associated with Alzheimer disease have often administered the cholinesterase inhibitor donepezil or the NMDA receptor antagonist memantine, despite their relatively meager benefits. In this first-ever meta-analysis of studies examining the concurrent use of these medications, investigators compared the combination of memantine and donepezil with donepezil monotherapy for moderate-to-severe Alzheimer disease.

Eleven studies were included, involving a total of 848 patients and typically prescribing medications for 24 weeks (range, 12–52 weeks). Dosages ranged from 5 to 10 mg/day for donepezil and 5 to 20 mg/day for memantine and were in many cases in…