Do you taper memantine after completion of 24 weeks of therapy?
There does not appear to be any guidance from the most recent published protocols on this topic. For individuals with dementia, recommendations call for a 50% dose reduction every 4 weeks.
Answer from: Radiation Oncologist at Academic Institution
Tapering is recommended when discontinuing some medications used in the management of dementia such as cholinesterase inhibitors. There are anecdotal cases of “discontinuation syndrome” after abrupt cessation of memantine in patients with dementia. However, this alone does not prove that...
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Radiation Oncologist at UC San Diego This is great. Thank you for the thorough response...
Radiation Oncologist at SUNY Upstate Medical University Thanks for the fantastic response!
Radiation Oncologist at Maimonides Cancer Center Thank you for this practical guidance!
Radiation Oncologist at Community Hospital Network Thank you for the response. I have had numerous pa...
Radiation Oncologist at Mayo Clinic Thank you for this interesting question. It is alw...
Radiation Oncologist at Community Hospital Network Thank you!
Answer from: Radiation Oncologist at Academic Institution
Interesting question. I have not tapered patients.
Medscape's reference page does not indicate it is necessary, and the protocols for RTOG/NRG trials do not mention tapering, to my knowledge. I wonder if @Paul D. Brown and @Minesh P. Mehta can weigh in here?
Answer from: Radiation Oncologist at Academic Institution
I have treated a number of patients on and off trial with memantine and have not tapered in any case. I have had patients attribute a number of toxicities to the drug (typically constitutional or gastrointestinal). If reassurance alone is unsuccessful, I allow them a short memantine break which usua...
Comments
Radiation Oncologist at UC San Diego Great, thank you!
Radiation Oncologist at University of Washington School of Medicine I have used memantine since 2011 and have not come...
This is great. Thank you for the thorough response...
Thanks for the fantastic response!
Thank you for this practical guidance!
Thank you for the response. I have had numerous pa...
Thank you for this interesting question. It is alw...
Thank you!