A review of a series of existing studies has concluded that a group of drugs used in the treatment of attention deficit hyperactivity disorder (ADHD), depression, and high blood pressure could also be useful for lowering apathy levels in those suffering from Alzheimer’s.
The medications covered in the research target noradrenaline which is a neurotransmitter in the peripheral as well as central nervous systems.
As Alzheimer’s disease first develops, the part of the brain responsible for controlling the release of noradrenaline can sustain damage. This, in turn, impacts on what is referred to as the noradrenergic system.
There is thought to be an association between the loss of cells in this area and the emergence of well-known dementia symptoms such as apathy, which is seen in about half or more of all dementia sufferers.
An Alzheimer’s patient suffering from heightened levels of apathy can be prone to ceasing activities that they once enjoyed, and they might struggle to perform even the simplest day-to-day tasks, such as making food and showering. This can then bring about a risk of other health issues.
“A dynamic two-way relationship between apathy and cognitive impairment”
Scientists from Imperial College London, University College London and the University of Cambridge sought to determine whether dementia symptoms such as apathy were treatable with drugs that target noradrenaline. In order to do this, they reviewed 19 previous studies in which 1,811 patients participated.
They found that the drugs were not only beneficial for the patients’ overall cognition, but also had an encouraging impact on efforts to reduce apathy and agitation.
Such findings raise the prospect of an effective Alzheimer’s treatment being developed relatively quickly, drawing upon already-available medication that targets the neurotransmitter.
One of the scientists behind the latest study, Imperial College London researcher Dr Michael David, commented: “Apathy is one of the most common symptoms in Alzheimer’s, and it is not fully understood.
“There is a dynamic, likely two-way, relationship between apathy and cognitive impairment, where dysfunction in the noradrenergic system could prevent patients from recognising things that require them to act – in essence creating an apathetic state.”
However, the researchers also underlined the importance of additional clinical trials being carried out, particularly to answer queries in relation to the dosage and how the drug interacts with other dementia medications.
Another Imperial College London academic who was involved in the new study, neurologist Dr Paresh Malhotra, stated: “At present there is no approved, specific medication for apathy in Alzheimer’s disease. The data for methylphenidate, a drug included in the current meta-analysis (a medication assessed within the safeMedicate platform), are promising, but there is no approved drug for this very common and disabling symptom.”
It is expected that further clinical trials will now be conducted by the group of scientists. Dr Malhotra is currently running a trial at Imperial of guanfacine, which is a noradrenergic medication.
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