“Good evidence” that ADHD drugs may also treat Alzheimer’s disease

There is “good evidence” that drugs that treat attention deficit hyperactivity disorder (ADHD) may successfully treat important aspects of Alzheimer’s disease, and find pooled data analysis of available studies online. Published in Journal of Neurology Neurosurgery & Psychiatry..

Clinical trials of noradrenaline agonists, including antidepressants and treatments High blood pressure ADHD is currently guaranteed, researchers say.

Noradrenaline agonists target the neurotransmitter noradrenaline, also known as norepinephrine, which is released by a network of specialized noradrenalinergic neurons.

This network is important for awakening and many Cognitive processIncludes attention, learning, memory, behavioral preparation, and suppression of inappropriate behavior.

Noradrenalinergic destruction occurs early in Alzheimer’s disease and contributes to the cognitive and neuropsychiatric symptoms that characterize the condition, and the noradrenalinergic system Drug treatment..

Therefore, the researchers searched Clinical trials Published between 1980 and 2021, noradrenaline agonists such as atomoxetine, methylphenidate, and guanfacine have been used to improve cognitive and / or neuropsychiatric symptoms in people with neurodegenerative diseases.

They included a total of 19 randomized controlled trials focused on Alzheimer’s disease. Mild cognitive impairment1811 patients involved: 6 of these trials were rated “good” quality, 7 were “normal”, and 6 were “bad”.

The results of 10 of these trials in 1300 patients were pooled for global cognition of direction / attention, memory, language fluency, language, and visuospatial competence.

This showed a small but significant positive effect of noradrenaline agonists on overall cognition, as measured by the Mini-Mental State Examination or the Alzheimer’s Disease Rating Scale.

Next, we pooled the results of eight clinical trials in 425 patients for behavior and neuropsychiatric symptoms, agitation and apathy. And this showed a significant positive effect of noradrenaline agonists on indifference, even after removing outliers to explain the difference between the study design and the intended results.

“The diversion of established noradrenaline agonists is most likely to provide. Effective treatment With Alzheimer’s disease for general cognition and indifference, “the researchers say.

They add: “There is a strong rationale for more targeted clinical trials of noradrenalinergic treatment in Alzheimer’s disease.”

But first there are some factors to consider, they warn. These include appropriately targeting specific patient groups, understanding the dose-effects of individual drugs and their interactions with other therapies, minimizing the weaknesses of noradrenaline agonists and maximizing their strengths. They say that is included.

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Alzheimer’s disease causes neuropsychiatric symptoms rather than cognitive decline

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For more information:
Cognitive and neuropsychiatric effects of noradrenalinergic treatment in Alzheimer’s disease: systematic review and meta-analysis, Journal of Neurology Neurosurgery & Psychiatry (2022). DOI: 10.1136 / jnnp-2022-329136

Provided by
British Medical Journal

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