In the guidance, NICE advises that memantine, an NMDA-receptor antagonist, should be offered to patients with moderate Alzheimer's who are intolerant of, or have a contraindication to, AChE inhibitors. NICE said the drug should also be offered to patients with severe disease.
Previously, NICE had not recommended memantine on cost effectiveness grounds, but has reversed its decision in light of new efficacy data.
NICE also extended its recommendation for the use of three acetylcholinesterase (AChE) inhibitors – donepezil, galantamine and rivastigmine – to include mild, as well as moderate, disease.
NICE chief executive Sir Andrew Dillon said: ‘Our increased confidence in the benefits and costs associated with the use of the three drugs for treating mild and moderate stages of the disease has enabled us to make a positive recommendation for their use in mild disease.’
A consultation on the guidance will run until 28 October.
