Ved moderat sykdomsgrad forventer arbeidsgruppen i gjennomsnitt noe bedre effekt av kolinesterasehemmere enn av memantin, men for pasienter som ikke viser effekt av kolinesterasehemmere, eller som ikke tolererer kolinesterasehemmere, anbefales det å tilby pasienten memantin.
Kombinasjonsbehandling med memantin og donepezil, sammenlignet med donepezil monoterapi, viser ingen dokumentert effekt på pasienter med mild til moderat grad av Alzheimers sykdom, verken på kognisjon, ADL-funksjon eller global funksjon.
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