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PubMed1995

Noncompetitive NMDA receptor antagonists with fast open-channel blocking kinetics and strong voltage-dependency as potential therapeutic agents for Alzheimer's dementia.

There is a growing body of evidence that disturbances of glutamatergic neurotransmission may underlie the pathomechanism and cognitive deficits of Alzheimer's disease. This review describes the potential use of low affinity, noncompetitive NMDA receptor antagonists in the treatment of this disease using memantine as an example. Evidence is presented indicating that this class of compound is neuroprotective in preclinical models of subchronic glutamate toxicity without producing side effects characteristic for other classes of NMDA receptor antagonist. This is attributed to their fast blocking kinetics and strong voltage dependency. Memantine also produces symptomatological improvement of cognition in animal models. The mechanism of action of this effect is still unclear but might be related to an enhancement of AMPA receptor mediated neurotransmission. In patients with dementia syndrome of various aetiologies, memantine produces a rapid onset, clinical improvement in various symptomatological deficits.

Alzheimer Disease↗
PubMed2003

Evaluation of possible pro- or antioxidative properties and of the interaction capacity with the microsomal cytochrome P450 system of different NMDA-receptor ligands and of taurine in vitro.

In the first part of the study possible additional antioxidative effects of various N-methyl-D-aspartate (NMDA)-receptor antagonists, some of which are used in the treatment of Parkinson's or Alzheimer's disease or as narcotic (dizocilpine, ketamine, budipine, memantine, amantadine, AP-5) were investigated in vitro in comparison to the respective agonists (NMDA, glutamate, aspartate, glycine) and the putative antioxidative amino acid taurine. For this purpose, effects on cytochrome P450 (P450) mediated oxidase functions in rat liver and brain microsomes were examined by measuring the influence on stimulated lipid peroxidation (LPO), H2O2 production, and lucigenin and luminol amplified chemiluminescence. Additionally, effects on rat whole blood chemiluminescence (WB-CL) were assessed. In the second part of the study the influence of the substances on P450 mediated monooxygenase functions in rat liver 9000 g supernatants, as assessed by the model reactions ethoxyresorufin O-deethylation (EROD), ethoxycoumarin O-deethylation (ECOD), and ethylmorphine N-demethylation (EMND), was investigated in order to evaluate possible interactions with the biotransformation of other foreign or endogenous substances. The non-competitive antagonists dizocilpine, ketamine, budipine and memantine concentration-dependently diminished all oxidase model reactions in both rat liver and brain microsomes. Amantadine was only slightly effective in brain microsomes and on LPO in liver microsomes. No noticeable effect was seen with the competitive antagonist AP-5, with all agonists and with taurine. WB-CL was diminished by all antagonists and by glutamate but not affected by the other agonists and taurine. Dizocilpine, ketamine, budipine and memantine concentration dependently inhibited EROD, ECOD and EMND, amantadine only EROD and ECOD activity. The other substances were without any effect. These results demonstrate that only the non-competitive NMDA-receptor antagonists seem to have antioxidative properties. On the other hand, only with the non-competitive antagonists interactions with the P450 system and thus with the biotransformation of other substances are to be expected.

Animals↗
PubMed1991

Modulation of glycine-activated membrane current by adamantane derivatives.

Pressure application of the inhibitory neurotransmitters glycine and GABA, respectively, evoked a Cl- current in spinal cord neurons of fetal mice in culture. Memantine, in low concentrations (0.3-5 microM) enhanced the glycine-mediated current at both negative and positive holding potentials. At concentrations of more than 5 microM, memantine increased the glycine-evoked current only when the membrane potential was positive. At negative potentials the current was inhibited. 3-isopropylamantadine and 3,5-diethylamantadine augmented the glycine-activated membrane current irrespective of the concentrations applied, whereas amantadine was ineffective. The GABA-activated Cl- current was not altered by the adamantanes. These data are evidence of a specific glycinergic interaction with putative antispastic agents and can explain some conflicting effects of memantine in experimentally induced seizures.

Adamantane↗
PubMed2004

Involvement of the sigma 1 receptor in the modulation of dopaminergic transmission by amantadine.

Pharmacological effects of amantadine on dopaminergic transmission are proposed to result from an uncompetitive antagonism at glutamate N-methyl-D-aspartate (NMDA) receptors. However, our previous studies examining amantadine-mediated dopamine receptor regulation in the rat striatum revealed a discrepancy from a direct interference with glutamate transmission. Preliminary in vitro binding data from the literature suggested the interaction of amantadine with the sigma1 receptor. Therefore, we have now further characterized the pharmacological properties of amantadine and memantine at this receptor and investigated its involvement in the modulation of striatal dopaminergic transmission. Our binding studies using [3H]-(+)SKF-10,047 indicated that amantadine and memantine behave as ligands of the sigma(1) receptor in rat forebrain homogenates (Ki values of 7.44 +/- 0.82 and 2.60 +/- 0.62 microm, respectively). In NG108-15 neuroblastoma cells, both drugs (amantadine (100 microm) and memantine (10 microm)) potentiated the bradykinin-induced mobilization of intracellular Ca2+, mimicking the effect of the sigma1 receptor agonist PRE-084 (1 microm). Finally, we previously showed that in striatal membranes from amantadine-treated rats, the functional coupling of dopamine receptors with G-proteins was enhanced. Similarly, PRE-084 dose-dependently increased the [35S]GTPgammaS binding induced by dopamine (Emax 28 and 26% of basal, 0.3 and 1 mg/kg PRE-084, respectively). By contrast, BD1047, which is without effect on its own, antagonized the effects of amantadine and PRE-084. Together, these data demonstrate that aminoadamantanes behave as sigma1 receptor agonists, and confirm an involvement of this receptor in modulating dopamine receptors exerted by therapeutically relevant concentrations of amantadine.

Amantadine↗
PubMed2006

Disease modifying therapy for AD?

Alzheimer's disease (AD) is the most common form of dementia in industrialized nations. If more effective therapies are not developed that either prevent AD or block progression of the disease in its very early stages, the economic and societal cost of caring for AD patients will be devastating. Only two types of drugs are currently approved for the treatment of AD: inhibitors of acetyl cholinesterase, which symptomatically enhance cognitive state to some degree but are not disease modifying; and the adamantane derivative, memantine. Memantine preferentially blocks excessive NMDA receptor activity without disrupting normal receptor activity and is thought to be a neuroprotective agent that blocks excitotoxicty. Memantine therefore may have a potentially disease modifying effect in multiple neurodegenerative conditions. An improved understanding of the pathogeneses of AD has now led to the identification of numerous therapeutic targets designed to alter amyloid beta protein (Abeta) or tau accumulation. Therapies that alter Abeta and tau through these various targets are likely to have significant disease modifying effects. Many of these targets have been validated in proof of concept studies in preclinical animal models, and some potentially disease modifying therapies targeting Abeta or tau are being tested in the clinic. This review will highlight both the promise of and the obstacles to developing such disease modifying AD therapies.

Alzheimer Disease↗
PubMed2006

The pharmacology of aminoadamantane nitrates.

Memantine, an aminodamantane, has recently been approved to treat moderate-to-severe Alzheimer's disease in the US after over 20 years on the market in Europe for treatment of Parkinson's disease. The unique properties of Memantine allow for its selective inhibition of abnormally active NMDA receptor channels while preserving normal glutamate activity and healthy neuronal function. Recently, it has been shown that compounds such as nitroglycerin, used for years for ischemic coronary disease, can also regulate the NMDA receptor channel. Novel compounds have been synthesized in an attempt to combine these activities, in an attempt to synergistically improve upon the activities of both nitrates and aminoadamantanes. We have subjected these compounds to several laboratory tests to compare their ability to affect the function of the NMDA receptor and to dilate blood vessels. These tests provide an initial indication of which of the compounds may have enhanced activity relative to memantine. The results also provide guidance for the synthesis of additional compounds that are likely to have the properties that are being sought.

Adamantane↗
PubMed2006

A systematic review of assessment and treatment of moderate to severe Alzheimer's disease.

OBJECTIVE: The systematic, large-scale study of therapies for moderate to severe Alzheimer's disease (AD) is a relatively recent advancement in the field. This review describes for the general practitioner the characterization of moderate to severe AD, discusses the development of metrics sensitive to the constellation of symptoms in these patients, and critically evaluates the use of those measures in moderate to severe AD clinical trials. DATA SOURCES: Published clinical trials obtained by MEDLINE searches used the following key words: moderate AD, severe AD, donepezil, rivastigmine, galantamine, memantine, and anti-dementia agents. Clinical trials were limited by language (English), study type (clinical trial), and publication dates (1990-2005). STUDY SELECTION: Nine clinical trials comprise the studies conducted to date in moderate to severe AD and include 5 prospective randomized clinical trials (3 for memantine, 2 for donepezil) and 4 retrospective subanalyses (2 for galantamine, 2 for rivastigmine) of primary datasets. DATA EXTRACTION: Clinical trials are summarized and major findings are reviewed. DATA SYNTHESIS: The data reviewed support the decision to initiate and maintain treatment in moderate to severe AD patients. CONCLUSIONS: The development and implementation of improved metrics for moderate to severe AD patients has revealed that meaningful benefits are attainable in this patient population by treatment with the N-methyl-D-aspartate receptor antagonist memantine. Evidence also indicates a benefit from cholinesterase inhibitor treatment, although further study of these agents in this patient population is warranted.

Journal Article↗
PubMed1992

NMDA antagonists disrupt timing behaviour in rats.

The behavioural effects of six compounds with N-methyl-D-aspartate (NMDA) antagonist properties were compared on the responding of rats maintained by a differential reinforcement of low rate 15s (DRL-15s) schedule. This schedule requires that responses be temporally spaced in order to be reinforced (timing behaviour). The number of reinforcers obtained was decreased by the non-competitive NMDA antagonists phencyclidine, dizocilpine and memantine, by the competitive NMDA antagonist CGS 19755, by the antitussive drug dextromethorphan, but not by the polyamine site antagonist eliprodil (SL 82.0715). Small increases in response rates were produced by phencyclidine and memantine, and dizocilpine gave rise to very marked increases in rates. CGS 19755, eliprodil and dextromethorphan only decreased rates of responding at high doses. Analysis of drug action in terms of inter-response times (IRT) showed that, except for eliprodil, all compounds shifted the peaks of the IRT distributions to the left. The percentage of short IRTs (response bursts) showed statistically significant increases after administration of dizocilpine, phencyclidine, memantine and CGS 19755. These results show that timing behaviour in rats is disturbed by several NMDA antagonists, although eliprodil, while decreasing responding at high doses, did not disrupt efficient timing.

Journal Article↗
PubMed1995

Comparison of glutamate antagonists in continuous multiple-trial and single-trial dark avoidance.

NMDA receptor antagonists (MK-801, memantine, amantadine, CGP37849), and the AMPA receptor antagonist NBQX, were tested in a continuous multiple-trial two-choice dark avoidance paradigm. During training MK-801 (0.2mg/kg) and CGP-37849 (12mg/kg) increased the number of trials to criterion. Amantadine (92mg/kg) increased all parameters except the number of trials to criterion. CGP37849 (6 and 12mg/kg) increased the number of shocks per trial. Injection of MK-801 (0.2mg/kg), memantine (20mg/kg), amantadine (92mg/kg) or CGP37849 (6 or 12mg/kg) before training decreased the latency to enter the dark compartment in the retention test 24h later. NBQX affected neither training nor retention parameters. NMDA antagonists were also tested in a single-trial two-choice dark avoidance procedure. Pre-training but not pre-retention test injection of MK-801 (0.2mg/kg), memantine (20mg/kg), amantadine (92mg/kg) or CGP37849 (12mg/kg) decreased the latency to enter the dark compartment during retention; scopolamine had similar effects. Hence, NMDA receptor antagonists, but not the AMPA receptor antagonist NBQX, impair memory storage which is also seen in animals trained to criterion, indicating that interference with the acquisition processes is not solely responsible for the memory deficit. This deficit occurs at doses that do not appear to interfere with the recall and the performance of the previously learned response.

Journal Article↗
PubMed1982

Effect of 1-aminoadamantanes on the MAO activity in brain, liver, and kidney of the rat.

In order to elucidate the possible interference of the antiparkinson drug 1-aminoadamantane (D-1, PK Merz) and the antispastic compound 1,3-dimethyl-5-aminoadamantane (DMAA, D-145, memantine, Memantine) on neurotransmitter metabolism, the effect of D-1 and its C-alkyl derivatives memantine, 1-amino-3,5,7-trimethyladamantane (D-191), and 1-amino-3-(n)-butyladamantane (D-178) on MAO activity in brain, liver, and kidney of the rat was investigated. A radioisotope method using [14C]5-hydroxytryptamine as substrate was used. The highest MAO activity was found in liver followed by brain and kidney (Vmax: 137, 64, and 26 nmol/mg protein X h, respectively). The Km values did not differ significantly for the three tissues (liver: 107 mumol/l; brain: 96 mumol/l; kidney: 86 mumol/l). The MAO activity in liver, brain and kidney was noncompetitively inhibited by all 1-aminoadamantanes studied, each derivative, respectively, showing in all three tissues about the same percentage inhibition. The inhibitory activity was found to be increased with the degree of C-alkylation: D-1 (Ki approximately 1 mmol/l) less than D-145 (Ki approximately 0.1 mmol/l) less than D-191 (Ki approximately 0.07 mmol/l) less than D 178 (Ki approximately 0.02 mmol/l).

Amantadine↗
PubMed2002

Electrophoretic behavior of adamantane derivatives possessing antiviral activity and their determination by capillary zone electrophoresis with indirect detection.

Separation and determination of adamantane derivatives with antiviral activity, namely amantadine (1-adamantan amine), memantine (1-amino-3,5-dimethyl adamantane) and rimantadine (alpha-methyl-1-adamantane methylamine), were examined by capillary zone electrophoresis. After optimization, an indirect detection method using 5 mM 4-methylbenzylamine in ethanol/water solution (1:4) as simultaneously absorbing and buffering background electrolyte with detection at 210 nm was found suitable for determination of the individual compounds (limit of detection was 0.35 mg L(-1) for memantine hydrochloride, S/N = 3). Baseline separation of all the three compounds was reached by addition of alpha- or beta-cyclodextrins to the electrolyte in concentrations of 20 and 2 mM, respectively.

Amantadine↗
PubMed2002

Glutamate receptors as a target for Alzheimer's disease--are clinical results supporting the hope?

Several years after the introduction of cholinergic drugs in Alzheimer's disease therapy, other approaches for symptomatic and also disease-modifying pharmacotherapy are progressing in their development. Among these, the NMDA antagonist memantine represents the most advanced and promising agent, gifted with many years of clinical experience in Germany. This paper provides an overview of both, the novel pharmacological background and recent clinical evidence in dementia. Memantine was recently recommended for central European approval.

Aged↗
PubMed1997

Drug therapy for acquired pendular nystagmus in multiple sclerosis.

Acquired pendular nystagmus (APN) is regularly accompanied by oscillopsia and impairment of static visual acuity. Therapeutic approaches to APN remain controversial, and there is no generally accepted therapeutic approach. We tested 14 patients who had suffered from APN caused by multiple sclerosis for several years; 12 patients presented with fixational pendular nystagmus (increasing during fixation) and 2 with spontaneous pendular nystagmus. All 11 patients with fixational pendular nystagmus who were given memantine, a glutamate antagonist, experienced complete cessation of the nystagmus. In contrast, scopolamine caused no (6 of 8) or only a minor (10-50%) reduction of the nystagmus (2 of 8). It was concluded that memantine is a safe treatment option for APN.

Adult↗
PubMed2000

The cytotoxicity of chronic neuroinflammation upon basal forebrain cholinergic neurons of rats can be attenuated by glutamatergic antagonism or cyclooxygenase-2 inhibition.

The proinflammagen lipopolysaccharide (LPS) was infused chronically (37 days) into the basal forebrain of rats. The current study determined whether the chronic administration of either a non-competitive N-methyl-D-aspartate- (NMDA-) sensitive receptor antagonist, memantine, or a selective cyclooxygenase-2 (COX2)/lipoxygenase inhibitor, CI987, could provide significant neuroprotection from the cytotoxic effects of LPS-induced neuroinflammation. Chronic LPS infusions decreased cortical choline acetyltransferase activity, which paralleled a decline in the number of choline-acetyltransferase-immunoreactive-cells within the basal forebrain as well as the number of activated resident microglia. The infusions appeared to be selective for cholinergic neurons. Peripheral administration of memantine (i.p.) or CI987 (s.c.) significantly attenuated the cytotoxic effects of the chronic inflammatory processes upon cholinergic cells within the basal forebrain. However, only CI987 attenuated the neuroinflammation produced by LPS and the subsequent changes in microglial activation. These results indicate that the cytotoxic effects of chronic neuroinflammation may involve prostanoid synthesis and may operate through NMDA receptors, and that the effects of prostaglandins occur upstream to NMDA-receptor activation.

Acetylcholine↗
PubMed1994

Investigations of neurotoxicity and neuroprotection within the nucleus basalis of the rat.

The present study investigated the specific ways by which cytotoxicity due to glutamate receptor stimulation could be attenuated by the administration of agonists and antagonists of the ionotropic and metabotropic glutamate receptors within the nucleus basalis magnocellularis (NBM) of rats as measured by cortical choline acetyltransferase activity. The results of these studies suggest that (1) the cytotoxicity of ibotenate to NBM cholinergic cells is not dependent upon stimulation of metabotropic glutamate receptors, but results from activation of N-methyl-D-aspartate (NMDA) receptors, (2) the cytotoxicity of quisqualate to cholinergic cells within the NBM is not dependent upon stimulation of NMDA or metabotropic receptors, and (3) the cytotoxicity of NMDA was prevented by administration (i.p.) of the un-competitive NMDA antagonist memantine (30 mg/kg), resulting in plasma levels of 2.5 micrograms/ml, a concentration known to block efficiently NMDA receptors in vitro. Finally, performance of a food-motivated, delayed-alternation task on a T-maze was impaired by injections of NMDA into the NBM, but was prevented by co-administration of NMDA with memantine.

Acetylcholine↗
PubMed1991

Effect of psychotropic agents on a model of absence epilepsy in rats.

The effect of different groups of psychotropic agents on the spontaneous absence-like paroxysms in the ECoG of rats was studied in order to evaluate the specificity of the model for antiabsence drugs. Morphine-like analgesics increased the number of paroxysms, whereas this was depressed or the discharges were completely abolished by the following drugs: d-amphetamine, tricyclic antidepressants, centrally acting anticholinergics and L-DOPA, NMDA antagonists and memantine. Since the latter drugs have been reported to be effective in petit mal epilepsy, or the NMDA antagonists and memantine, have a potential anticonvulsant effect, the results are in favour of the usefulness of the model for antiabsence drugs.

Animals↗
PubMed1996

Discriminative stimulus effects of the NMDA receptor antagonists MK-801 and CGP 37849 in rats.

Rats were trained to discriminate MK-801 (0.05 mg/kg, IP), an uncompetitive, or CGP 37849 (3 mg/kg, IP), a competitive NMDA receptor antagonist from saline, using a two-lever, operant drug discrimination paradigm. In generalization tests the role of dopaminergic and serotonergic systems in the discriminative stimulus effects produced by both NMDA receptor antagonists was studied with amphetamine (0.5 mg/kg), cocaine (5.0 and 7.5 mg/kg), and fenfluramine (2.5 and 5.0 mg/kg). Additionally, memantine (5.0, 7.5 and 10.0 mg/kg), an uncompetitive NMDA receptor antagonist, was tested. The discriminative stimuli produced by MK-801 and CGP 37849 were not generalized to each other. Among the tested drugs only memantine generalized to the MK-801 discriminative stimulus. None of the tested drugs showed CGP 37849-like discriminative stimulus properties. The different mechanisms underlying NMDA antagonism by MK-801 and GP 37849 might explain the observed lack of cross-generalization. The results suggest that dopaminergic and serotonergic systems are not of major importance in the discriminative stimulus effects produced by both MK-801 and CGP 37849.

2-Amino-5-phosphonovalerate↗
PubMed2006

NMDA receptor-mediated excitotoxicity contributes to the cerebral hypoxic injury of a rat model of posthypoxic myoclonus.

Cardiac arrest-induced cerebral hypoxic injury could induce posthypoxic movement disorders. Here we investigated the effects of memantine, an NMDA receptor channel blocker, on the neurodegeneration occurred in an established rat model of posthypoxic myoclonus. We found that administration of memantine for 7 days significantly reduced cerebral hypoxia-induced neurodegeneration in the CA1 of the hippocampus, the reticular thalamic nucleus (RTN) and the primary fissure of the cerebellum of the posthypoxic animals. The results suggest that the neurodegeneration observed in specific areas of the brain of the posthypoxic rats is contributed by NMDA receptor-mediated excitotoxicity.

Animals↗