Comparative analysis of the effectiveness of donepezil monotherapy and combination therapy with donepezil and akatinol memantine in patients with Alzheimer's disease at the stage of mild dementia

The standard for the treatment of dementia in Alzheimer's disease (AD) is the use of basic medicines affecting the cholinergic and glutamatergic systems.

The aim of the study was a comparative evaluation of combined treatment with an NMDA receptor antagonist akatinol memantine and donepezil — acetylcholinesterase  inhibitor, compared with donepezil monotherapy in AD patients with mild dementia.

Material and methods. The study included 35 patients with AD (average age 78.51 years old ± 6.08) at the stage of mild dementia. 35% of patients received donepezil monotherapy (alzepil), 65% of patients received donepezil and akatinol memantine combined treatment. The observation period was 12 months. During this period, the patients underwent a neuropsychological examination every 3 months. It included a Mini Mental State Examination, Frontal assessment battery, memory test with an assessment of immediate and delayed reproduction of «12 words», verbal fluency (phonetic and semantic), clock drawing test, Trial making test, part A.

Results. In patients, who received the combined treatment, improvement was detected on almost all cognitive scales, in 3 months of the therapy. It continued to increase throughout the whole observation period. And, contrary-wise, in patients, who received monotherapy, only stabilization of cognitive status was manifested.

Conclusion. The administration of combined treatment with akatinol memantine and donepezil to patients with AD at the stage of mild dementia during the period of 12 months, is more effective than donepezil monotherapy.

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