Memantine: update on the current evidence.

Nine years after the initial approval of a cholinergic drug for the treatment of Alzheimer's Disease in the USA, a compound with a different pharmacological approach, namely the NMDA antagonist memantine, has been approved for the first time in Europe in 2002. This event led to an enhanced perception of a decade of basic research work on its mode of action. At the same time, additional preclinical data, e.g. on memantine's effects on the hyperphosphorylation of tau, and clinical trial results, e.g. on the glutamatergic-cholinergic combination therapy, are being reported. The present paper attempts to provide an update on the currently available pharmacological and clinical evidence on memantine, including earlier clincial data, e.g. in vascular dementia. As the clinical database broadens, and various additional conditions are being tested in ongoing controlled clinical trials, we are approaching an ever more precise profile of memantine's spectrum of safety and tolerability, and also varied efficacy-hopefully resulting in another useful tool in the clinician's hands to fight previously untreatable neurodegenerative disease. Copyright 2003 John Wiley & Sons, Ltd.