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	Since this article does not have an abstract, we have provided the first 115 words of the full text and any section headings.

To the Editor: Dr Tariot and colleagues¹ reported that among patients with moderate to severe Alzheimer disease (AD) receiving stable doses of donepezil, memantine resulted in significantly better outcomes than placebo on measures of cognition, activities of daily living, global outcome, and behavior and was well-tolerated. However, the authors did not describe whether the caregivers of these patients noticed a difference or whether life was made better for them or for the patients.

The cost for a month of memantine and donepezil together is about $300 in pharmacies in my area. It is unclear whether there is any real clinical benefit to patient or caregiver and, if there is, whether it is worth this cost.

Thomas E. Finucane, MD
tfinucan{at}jhmi.edu
Johns Hopkins Bayview Medical Center
Baltimore, Md

1. Tariot PN, Farlow MR, Grossberg GT, Graham SM, McDonald S, Gergel I, for the Memantine Study Group. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepazil: a randomized controlled trial. JAMA. 2004;291:317-324. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:1695.

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