Treatments
Memantine (Namenda)
Memantine is approved for moderate-to-severe Alzheimer's. It works differently from donepezil and is often added on top rather than instead.
Updated 2026-02-20
Written and clinically reviewed by Ashlee Skabla Velez, APRN, ACNPC-AG
Dementia care and caregiver-support specialist
Need help applying this to your situation?
How it works
Memantine modulates glutamate — a different brain chemical from acetylcholine. It can soften agitation, improve attention, and reduce some behavioral symptoms in moderate-to-severe disease.
Starting it
- Usually titrated up from 5 mg to 20 mg/day over 4 weeks.
- Often combined with donepezil — there's a combination pill, Namzaric.
- Generally well-tolerated. Less nausea than cholinesterase inhibitors.
- Watch for dizziness, confusion, headache initially.
Frequently asked questions
- Will it help in early-stage?
- Memantine isn't approved or well-studied in early-stage Alzheimer's. Most prescribers wait for moderate disease.
Every dementia journey is different.
Memory Lane Care helps you understand what applies to your loved one, what to expect next, and which resources fit your family's situation.
Need help applying this to your situation?
Related across the journey
Memory Lane connects every part of dementia care. Here's how this topic threads into the rest.
Behavior Guidance
Hard Conversations
Resources
Keep reading
Treatments
Donepezil (Aricept)
Donepezil is the most prescribed dementia medication in the world. It doesn't cure, doesn't stop progression, but in many people it sharpens day-to-day function modestly.
Treatments
Rivastigmine (Exelon)
Rivastigmine works similarly to donepezil but delivered through a daily skin patch. Many families prefer the patch when swallowing pills becomes harder.
Learning
The stages of dementia
Dementia is progressive — symptoms worsen over time — but the path is never identical between people. Knowing the stages helps you plan, not predict.
Learning
Alzheimer's vs dementia — what's the difference?
Dementia describes the symptoms. Alzheimer's is one specific disease that causes them — the most common one, but not the only one.
Treatments
Lecanemab (Leqembi)
Lecanemab is one of the first FDA-approved infusions that clears amyloid plaques from the brain. It's not a cure — it slows decline modestly in early Alzheimer's.
Treatments
Donanemab (Kisunla)
Donanemab is the second FDA-approved amyloid-clearing infusion for early Alzheimer's. Unlike Lecanemab, it stops once amyloid is cleared from the brain.
Treatments
Brexpiprazole (Rexulti) for Alzheimer's agitation
Brexpiprazole became the first FDA-approved medication for Alzheimer's-related agitation in 2023. It's helpful for some — but it's a serious medication.
Learning
Lewy body dementia
Lewy body dementia (LBD) is the third most common dementia. It shows up differently — visual hallucinations, sleep behaviors, Parkinson-like stiffness — and is dangerous to treat with the wrong medications.