Memantine for FTD: What You Need to Know About This Medication

When memantine, a medication approved for moderate to severe Alzheimer’s disease that works by regulating glutamate activity in the brain. Also known as Namenda, it is sometimes prescribed off-label for people with frontotemporal dementia, a group of disorders caused by progressive nerve cell loss in the brain’s frontal and temporal lobes, leading to changes in behavior, language, and decision-making. Unlike Alzheimer’s, where memory loss is the main symptom, FTD often shows up as personality shifts, impulsivity, or loss of empathy. Memantine doesn’t stop the disease, but it can help slow down the worsening of symptoms in some patients—especially when behavioral issues like agitation or aggression become hard to manage.

Why memantine? It works by blocking excess glutamate, a chemical in the brain that can become toxic when overproduced. Too much glutamate is linked to nerve cell damage, and while this is well-studied in Alzheimer’s, researchers are now looking at whether the same mechanism helps in FTD. Clinical trials haven’t shown dramatic improvements, but many caregivers report calmer behavior, fewer outbursts, and better sleep after starting memantine. It’s not a cure, but for families dealing with daily chaos, even small improvements matter. It’s also one of the few medications with a low risk of serious side effects compared to antipsychotics, which are often used but carry higher risks like stroke or sudden death in older adults with dementia.

Memantine for FTD is usually started at a low dose—5 mg once a day—and slowly increased over weeks to 10 mg twice daily. It’s taken orally, often as a tablet or liquid, and most people tolerate it well. Common side effects? Dizziness, headache, or constipation—mild and usually temporary. What’s missing from the research? Long-term data specific to FTD. Most studies are small or combine FTD with other dementias. Still, neurologists often try it because the risks are low and the potential upside is real: fewer hospital visits, less strain on caregivers, and more stable days at home.

It’s not for everyone. If someone has kidney problems, the dose needs adjusting. If they’re already on other NMDA blockers like amantadine, combining them isn’t recommended. And memantine won’t fix language loss or apathy in every case—those symptoms often need different strategies, like speech therapy or structured routines. But when behavioral symptoms are the biggest challenge, memantine gives families a tool that’s simple, safe, and worth trying.

Below, you’ll find real-world insights from patients and doctors on how memantine fits into daily care, what to watch for, and how it compares with other options for managing FTD symptoms.