Does your loved one, perhaps your mother, father, grandmother or grandfather, have Alzheimer's disease? We all know the sadness and helplessness that comes with gradually losing memory and forgetting familiar faces. Alzheimer's disease is actually a condition that can lead to memory loss, brain damage and even death. Although there is no cure for this disease, there are medications that can slow it down and provide some relief to the patient. Today we are going to talk about one such special class of drugs. That is NMDA Receptor Antagonists . Although the name is a bit complicated, let's understand it simply.
A little chemical story that happens in the brain
Our brain is an amazing place. It contains billions of nerve cells, or `neurons`. These cells process information, remember information, and tell other parts of the body what to do by sending electrical and chemical signals back and forth to each other.
We call the messengers that carry these chemical signals `neurotransmitters`. One of those messengers is `glutamate` .
Simply think of glutamate as a boat that carries a message from one nerve cell to another. This boat needs a special dock to go to the other cell and dock. That dock is what we call the NMDA receptor (`N-methyl-D-aspartate` receptor. When the boat called glutamate attaches to this NMDA port, it sends another important substance called `calcium` into the cell. This calcium is what completes that message and helps us learn and remember something. This is a normal process in a healthy brain.
So what happens in Alzheimer's disease?
In the brain cells of someone with Alzheimer's disease , too much glutamate starts to be produced . What happens is that too much calcium flows into those nerve cells. Imagine what happens if you fill a water tank with too much water? It overflows. Similarly, when too much calcium accumulates inside the cells, those cells start to be damaged. This damage is what gradually increases the symptoms of Alzheimer's.
Here's how NMDA Receptor Antagonists help
The class of drugs called NMDA receptor antagonists works by reducing the number of places where those extra glutamate boats can dock at the NMDA receptor. That is, the drug blocks some of the ports. But the most important thing is that these drugs allow essential messages to flow . That is, they only control the destructive influx of calcium without causing any major disruption to the normal functioning of the brain. This reduces the damage to nerve cells and controls the speed of the disease.
In treating Alzheimer's disease, doctors most often use drugs that target another neurotransmitter called acetylcholine. But NMDA receptor antagonists are an important class of drugs that work in a different way.
The main NMDA receptor antagonist currently approved for the treatment of Alzheimer's disease is memantine (brand name `Namenda XR`). It is usually prescribed by doctors for moderate to severe stages of the disease. Sometimes, memantine is given in combination with the previously mentioned `cholinesterase inhibitors`, which increase acetylcholine levels. This can lead to better results in some patients.
But remember, these medications don't work the same for everyone.
Let's also be aware of the side effects.
Like all medications, this one can have minor side effects.
- Dizziness is the most common symptom.
- In addition, things like headaches and constipation may also occur.
- Very rarely, there is a possibility of confusion in the brain .
If you or your patient experience any of these, you should inform your doctor immediately . It is never a good idea to stop taking medication or change the dosage on your own.
Other drugs in this family and their uses
There are other drugs in this family called NMDA receptor antagonists. Some of them we see in everyday life. Some are a little more dangerous, and are abused as drugs. Scientists are also researching the benefits of this class of drugs for other neurological diseases, such as Parkinson's disease and ALS (amyotrophic lateral sclerosis).
Let's learn more about it from the table below.
| Drug Name | Main use | Important points and risks |
|---|---|---|
| Dextromethorphan | It is contained in cough syrups. | Generally safe, but can be dangerous if taken in high doses. |
| Ketamine | An anesthetic drug (for humans and animals). | Used to relieve pain during surgery. But abused as a "club drug". Can cause hallucinations and feelings of detachment. Research is underway on its use for conditions such as depression. |
| Phencyclidine (PCP) | Abused as a drug. | Originally developed as an anesthetic, it was withdrawn from use due to severe side effects (hallucinations, confusion). A dangerous drug known as "Angel Dust". Linked to violent behavior. |
Take-Home Message
- Although Alzheimer's disease cannot be completely cured, NMDA receptor antagonist drugs such as memantine can help manage moderate to severe stages of the disease by reducing damage to brain cells.
- These drugs work by protecting nerve cells from excess glutamate in the brain.
- As with any medication, side effects such as dizziness can occur. Always discuss this with your doctor. Never change the dosage or stop taking the medication on your own.
- This class of drugs, such as Ketamine and PCP, are abused as narcotics and are very dangerous. There is a big difference between these and the medications prescribed for Alzheimer's disease.
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