MAGD: Memantine for Agitation in Dementia
We plan to evaluate the use of memantine in Alzheimer's disease to control agitation in the acute situation i.e under 12 weeks
Agitation is a cause of morbidity and mortality in Alzheimer's due to distress and use of medication with side effects. Memantine has beed shown to be associated with less agitation and a recent study by forrest pharmaceuticals failed to recruit. We will perform a 12 week rct in 164 patients to test this hypothesis in a locality with no competing studies and in a clinical setting where the drug is not often used. We will compare with placebo and also use a rescue protocol derived from international best practice.
Primary Outcome Measures
- Cohen-Mansfield [2 weeks]
Secondary Outcome Measures
- Neuropsychiatric Inventory 6+12 weeks [2 weeks]
- Clinical Global Impression 6+ 12 weeks [2 weeks]
- Severe Impairment Battery 6+12 weeks [2 weeks]
- Quality of Life 6+12 weeks [2 weeks]
- Co-meds [2 weeks]
- Incidents of agitation [2 weeks]
- Use of rescue protocol [2 weeks]
Residential/Inpatients at recruitment to the study with a history of at least 2 weeks behavioural disturbance.
Alzheimer's Disease only as per McKhann Criteria + Hachinski Score<=4.
Moderately severe to severe Alzheimer's Disease (baseline MMSE </=19).
Clinically significant agitation that requires treatment.
Severity of agitation defined by Cohen Mansfield agitation inventory (CMAI) > /=45.
Age >/= 55.
Memantine usage in the 4 weeks prior to the start of the study.
On Cholinesterase inhibitor for less than 3 months and not on a stable dose.
Anti-psychotic, anti-epileptic, antidepressant, benzodiazepine, lithium or hypnotic dosage alteration in the 2 weeks prior to the start of the study.
Hypersensitivity to memantine or any of the excipients in the formulation.
Severe renal impairment.
Epilepsy, history of convulsions or seizure, or receiving any anti-epileptic treatment.
Concomitant usage of N-methyl-D-aspartate (NMDA) antagonists such as amantadine, ketamine or dextromethorphan.
Recent myocardial infarction, uncompensated congestive heart failure and uncontrolled hypertension.
Severe, unstable or poorly controlled medical illness.
Any disability that may interfere with the patient completing the study procedure.
Delirium, pain or any medical illness as a clear cause of agitation.
Any important drug interactions: Prohibited during study and in the 14 days preceding enrollment/inclusion are: Analgesic dextromethorphan, Dopaminergics- amantadine, Warfarin due to theoretical INR prolongation.
Contacts and Locations
|1||Oxleas Nhs Foundation Trust||Dartford||Kent||United Kingdom||DA2 7WG|
|2||Kent and Medway NHS and Social Care Partnership Trust||Folkestone||Kent||United Kingdom||ct20 1jy|
Sponsors and Collaborators
- East Kent Hospitals University NHS Foundation Trust
- University of Oxford
- Institute of Psychiatry, London
- University of London
- University College, London
- Indiana University School of Medicine
- Principal Investigator: CHRIS FOX, MBBSBscMSC, KENT AND MEDWAY NHS AND SOCIAL CARE PARTNERSHIP TRUST
Study Documents (Full-Text)None provided.
- ISRCTN 24953404