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

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.

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