The Effect Of Memantine Combined With Donepezil In The Treatment Of Parkinson's Disease Dementia:A Meta-analysis

Objective: Parkinson's disease(PD)is the second most common neurodegenerative disease after Alzheimer's disease(AD).In the past decades,more and more evidences have shown that various non-motor symptoms negatively affect life quality of PD patients.PDD is the most devastating non-exercise complication of Parkinson's disease,which seriously affects the prognosis and quality of life of patients and their caregivers.This study is conducted to investigate the efficacy and safety of memantine combined with donepezil in the treatment of PDD compared with that of donepezil alone by Meta analysis.Methods: The relevant electronic databases were searched by computer,including Chinese Knowledge Network,Weipu database and Wanfang database.Memantine combined with donepezil in the treatment of PDD was the study group and donepezil in the treatment of PDD was the control group.For the relevant RCT literature,the search deadline was February 2019.The data was processed using Revman 5.3 software after screening literature,data extraction and quality assessment.The Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(Mo CA)and Ability of Daily Living(ADL)were expressed by standardized mean difference(SMD)and95% confidence interval.Adverse effects were expressed by relative risk(RR)and 95% confidence interval.Results: A total of six randomized controlled trials(RCTs)were included,with a total of 548 patients.Meta-analysis showed that in patients with PDD,compared with the donepezil group,the Mo CA scores of memantine combined with donepezil group were increased,the difference was statistically significant(SMD=0.90,95%CI=0.70,1.11,P<0.00001),MMSE scores were increased,the difference was statistically significant(SMD=0.97,95%CI=0.67,1.28,P<0.00001),ADL scores were increased,the difference was statistically significant(SMD= 1.50,95% CI = 1.16,1.85,P<0.00001).There were no significant difference in adverse effects between the two groups(RR=1.16,95% CI=0.75,1.78,P=0.50).Conclusion: Compared with the donepezil group,the memantine combined with donepezil group significantly affects Mo CA,MMSE and ADL scores,and the effect is obvious.There is no significant difference in adverse effects,suggesting that memantine and donepezil can be tolerated clinically.Memantine combined with donepezil in the treatment of PDD patients do not significantly increase the incidence of adverse effects.