Cholinesterase Inhibitors + Glutamate Regulators

Several kinds of drugs are approved to treat the cognitive symptoms of Alzheimer's disease. Cognitive symptoms include problems with memory, thinking, and language. One common treatment approach is combining two different types of drugs: cholinesterase inhibitors and glutamate regulators.^1,2

This combination helps manage symptoms in people with moderate to severe dementia. While these treatments help with memory and thinking, they do not cure the underlying disease. They also do not stop the disease from getting worse over time.^1,2

How this treatment approach works

The 2 types of drugs in this treatment approach work in different ways to help the brain function better.^1,2

Glutamate regulators

Memantine is a common glutamate regulator. It works by blocking a chemical messenger called glutamate. Nerve cells damaged by Alzheimer's often make too much glutamate. Over time, too much glutamate causes more damage to nerve cells. By blocking some of this glutamate, memantine protects nerve cells from further damage.^1,2

Cholinesterase Inhibitors

Donepezil is a common cholinesterase inhibitor. It works by slowing down the breakdown of a chemical messenger called acetylcholine. Acetylcholine sends messages between nerve cells and the brain. By keeping levels of acetylcholine higher, donepezil improves the way nerve cells talk to each other.^1,2

Some people take these two drugs separately. Others take a single pill that combines them, such as Namzaric® (memantine and donepezil).^1,2

What are the possible side effects?

Side effects can vary depending on the specific drug you take. The most common side effects of this combination treatment include:^1,2

• Headache
• Diarrhea
• Dizziness
• Loss of appetite
• Bruising

These are not all the possible side effects of these treatments. Talk to your doctor about what to expect when taking a cholinesterase inhibitor or a glutamate regulator. You also should call your doctor if you have any changes that concern you during treatment.^1,2

Other things to know

Before starting treatment for Alzheimer's disease, tell your doctor if you have any of the following:^1,2

• Heart problems, such as a slow or irregular heartbeat
• Asthma or lung problems
• Seizures
• Stomach ulcers
• Bladder or kidney problems
• Liver problems
• Upcoming medical or dental procedures where you will need anesthesia

There is not enough data to know if these drugs are safe to take while pregnant or breastfeeding. If you are pregnant or planning to become pregnant, talk to your doctor to see if these treatments are right for you.

Before beginning any treatment for Alzheimer's disease, tell your doctor about all your health conditions. You should also share a list of all drugs, vitamins, or supplements you take. This includes over-the-counter drugs.