Huang_2026_Am.J.Health.Syst.Pharm__

PURPOSE: Dementia with Lewy bodies (DLB) ranks among the most frequent neurodegenerative cognitive disorders, characterized by multi-domain deficits including autonomic dysfunction and fluctuating cognition. Current management remains symptomatic, particularly in patients with comorbidities limiting standard therapies. SUMMARY: We report a 73-year-old female with DLB and pre-existing cardiac conduction defects, rendering cholinesterase inhibitors contraindicated. Following memantine (10 mg/day) treatment over three months, changes in autonomic and cognitive measures were observed. Heart rate variability parameters increased, accompanied by a reduction in SCOPA-AUT score and an increase in MMSE score. No adverse events were observed. CONCLUSION: These findings suggest memantine as a potential therapeutic alternative for DLB patients with autonomic fragility.