THE USE OF MEMANTINE IN PATIENTS WITH ALZHEIMER’S DISEASE

Resumo

Introduction: Alzheimer is a progressive neurodegenerative dysfunction, which causes a decrease in cognitive functions, causing an atrophy of the cerebral cortex, leading to the decline of cognitive functions, limiting the social capacities, both in the behavior and in the personality of the individual. (SERENIKI, 2008). It is not known for certain what the cause of this disease is, but the glutamatergic hypothesis says that in some specific conditions, as in the case of the variation of the energetic metabolism of the cell, an excessive stimulation process occurs of the NMDA receptors, being able to initiate the process of neuronal apoptosis. This hypothesis is based on the fact that this glutamatedependent "excito-toxicity" constitutes one of the pathogenic mechanisms necessary for the neurodegenerative process of Alzheimer's disease to be maintained and developed (FALCO, 2016). The objective of this article was to present an overall review about the use of Memantine on Alzheimer patients.
Material and Methods: The data were obtained at Scientific Electronic Library Online (SciELO) and MEDLINE, referring to articles in both Portuguese and English in the last 10 years, with the use of keywords Alzheimer, Memantine and chronic treatment. On this research, more than 1018 articles on the subject were found in the data banks, been used only those referring to the specific case of the disease being treated.
Results: Studies are usually performed in patients with Alzheimer's disease (AD) in severe and moderate degrees. The studies show that in the majority of the patients who use memantine there is an improvement in the functional standards, with good tolerability, with a reduction in dependence on care. (CHEN, 2017) This drug is a non-competitive antagonist of moderate affinity to N-methyl-D-aspartate (NMDA) receptors, responsible for its physiological activation in memory formation processes. It performs the blockade of these receptors in their resting state, moving from its binding site when under physiological activation conditions, but not doing so in the cases of pathological activation, thus presenting a neuroprotective action that opposes the excitotoxic activation of the receptors of glutamate. (LIMA, 2008).
Discussion and Conclusion: The pharmacology currently recommended for Alzheimer's disease consists of cholinesterase inhibitors and memantine. Research suggests that patients with moderate to severe stages of AD may benefit from antiglutaminic treatment, reducing the progression of disease-specific deterioration, especially with regard to daily living (LIMA, 2008). Memantine is a drug that is associated with both cognitive and functional improvements in the patients who perform its use, in addition to bringing behavioral benefits to the user. However, it is worth noting that despite the improvements mentioned, this is a palliative medication, that is, it will not change the course of the disease (FALCO, 2016). From these results, it is noticed that new scientific research is necessary for the development of pharmacological and more effective therapies. It is also essential that a better training of professionals is
carried out to make the diagnosis and start treating the problem in an early manner, in order to improve the quality of life of both patients and their families (SERENIKI, 2008).