Posts Tagged ‘Cholinesterase Inhibitors’

Layman's Explanation Dimebon / Dimebolin Treatment Alzheimer's Disease Current Dimebon Studies Underway

Saturday, August 15th, 2009

Researchers have reported promising results for a new Alzheimer’s drug. We take a close look at the evidence, to see whether it might offer a new option for treatment.

What is Known At this Point in Time for the Treatment of Alzheimer’s Disease ?

Alzheimer’s disease is the most common cause of dementia in older people. If someone has dementia, they have trouble with memory and thinking. Their behavior often changes, and eventually they become unable to look after themselves.

There are several treatments to help with the symptoms of dementia, although none of them can cure it. Drugs called cholinesterase inhibitors seem to slow the progress of dementia in some people. However, there’s been a lot of controversy about how well these drugs work.

The National Institute for Health and Clinical Excellence (NICE) is the organisation that decides which treatments can be offered on the NHS. NICE says that three different cholinesterase inhibitors can be used on the NHS, but only for people with moderate Alzheimer’s disease. The drugs aren’t recommended for people in the early stages of Alzheimer’s.

Dementia is likely to be a big problem in future years, as people are living longer on average, so are more likely to get dementia. Doctors are looking for more treatments that may be useful for dementia. One drug being studied at the moment is called dimebon. It’s an antihistamine that was once used to treat allergies. But it was dropped when other allergy drugs were developed. Now, doctors are looking to see if it’s helpful for Alzheimer’s disease.

What does the new study say?

Dimebon worked better than a dummy (placebo) drug for people with mild to moderate Alzheimer’s disease, over six months to a year. People taking dimebon had improved test scores for thinking and memory. People taking the placebo had scores that got worse over the course of the study.

Researchers found the same results using several different tests, all of which looked mainly at how well people could think and remember things.

Tell me more about the study’s findings

The improvement in test scores happened mostly in the first three to six months of the study. Towards the end of 12 months, the average test scores for people taking dimebon had started to go down. But, because the test scores for people who took a placebo went down steadily during the whole 12 months, the people taking dimebon did much better by comparison at the end of the year.

It’s hard to know exactly what the test scores mean. The main test used has a maximum of 70 points. People taking dimebon did about 4 points better than people taking placebo after six months, and 7 points better after a year. That’s a big enough difference for a doctor to notice. But it’s hard to say what that means for the patient. For example, we don’t know whether it would mean someone could stay in their own home, rather than needing care in a nursing home.

People in the study didn’t get many serious side effects from dimebon. A dry mouth was the most common side effect.

Where does the study come from?

The study was carried out in Moscow, Russia, but overseen by researchers at the Baylor College of Medicine in Houston, Texas. It was published in The Lancet, a medical journal owned by a publishing company called Elsevier. It was funded by Medivation, the US company that makes and wants to sell dimebon. It’s quite common for medicine manufacturers to fund medical trials of their drugs.

How reliable are the findings?

The trial was carried out carefully, and over enough time that it should show a real result. It was a type of study called a randomised controlled trial, which is the best sort of study to see if one drug works better than another, or better than a placebo. However, there are some things that should make us cautious.

  • It’s not a very big study. Only 183 patients took part.
  • All the patients were in Russian hospitals. Treatment of Alzheimer’s disease is quite different in Russia, compared to the UK. People tend to be in big wards, in hospitals, and the drugs used in the UK are not widely available. So it’s hard to know whether these results would be the same if the drug was tested in the UK.

The study didn’t compare dimebon with existing drugs for Alzheimer’s disease. It seems to be better than no treatment at all, but we can’t say whether it’s better or worse than the drugs we have already.

What does this mean for me?

If you have Alzheimer’s, or you are caring for someone with the disease, you’ll probably be keen to hear about any potential new treatment. This new study gives some hope that dimebon might be a useful option. But we need to see more research to be sure. Even if more studies show it works well, it’s likely to be several years before dimebon is available as a treatment for Alzheimer’s.

Current Choice Actions for Friends & Family Suffering from Alzheimer’s Disease Dementia

There’s no need to take any action as a result of this study. If you care for someone with Alzheimer’s disease and are worried about their treatment, see your doctor. There are currently three drugs approved in the UK to treat moderate Alzheimer’s. They’re called donepezil, galantamine and rivastigmine.

http://www.guardian.co.uk/lifeandstyle/besttreatments/2008/jul/18/new-alzheimers-treatment-tested

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Cholinesterase Inhibitors – Their Use and Withdrawl of Treatment

Sunday, April 19th, 2009

The cholinteresterase inhibitors thus far available  are currently only approved by the F.D.A. (The US Food and Drug Administration)  , are approved by the FDA as only being effective for Alzherimer patients who have thus far mild to moderate disease.  However these drugs and medications – that is the cholinesterase classification medication grouping, may well show promise for those who are in the earliest as well as later stages of the disease , as well.  In addition they could well be of benefit and benefits to those with mil cognitive impairment as well.

One large study evaluated the use of Aricept (dozepezil) in the treatment of mild cognitive  impairment and found that it significantly reduced conversion to active Alzheimer’s progressive disease.

Current Treatment for Alzheimer’s Disease – Prescription cholinesterase inhibitors include Exelon and Aricept. These drugs have varying side effects and can have contraindications with other medication, so it can be difficult for doctors to find the right pharmaceutical match and …

Methods and compositions using cholinesterase inhibitors – The invention provides methods for treating and/or preventing Alzheimer’s disease, psychiatric illnesses, encephalitis, meningitis, fetal alcohol syndrome, Karsakoff’s syndrome, anoxic brain injury, cardiopulmonary resuscitation …

alzheimer disease – These drugs are called cholinesterase inhibitors because they inhibit the enzymes that break down acetylcholine (acetylcholinesterase and butyrylcholinesterase). Some drugs target only acetylcholinesterase, whereas some target both …

Galantamine: Welsh daffodils containing galantamine may help fight … – Galantamine is a competitive and reversible cholinesterase inhibitor. It is believed it works by enhancing cholinergic function by increasing the concentration of acetylcholine in the brain. The atomics resolution 3D structure of the …

Cholinesterase Inhibitors Reduce Aggression, Wandering And … – Cholinesterase Inhibitors Reduce Aggression, Wandering And Paranoia In Alzheimer’s Disease.

While cholinesterase inhibitors are now believed to he most helpful in persons with severe Alzheimer’s disease ,sometimes patients can be maintained on these classes and classifications of drugs indefinitely due to the fact and observation that in clinical practice , that often patients who stop taking these drugs or types of medications deteriorate rapidly when the drugs are arbitrarily stopped or withdrawn.  Indeed there is new and upcoming evidence from studies that suggest that stopping cholinesterase inhibitors will result in decline in functioning to a level that the patient would have been at it they – he or she – had not been taking the drug in the first place.

In addition drugs in this class appear to have an added benefit in improving behaviour as well as overall cognitive abilities.

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Cholinesterase Inhibitors in the Treatment of Alzheimer's Disease

Friday, April 17th, 2009

Perhaps the most prescribed category of drugs for Alzhimer’s disease are the “Cholinesterase Inhibitor”  branch.  This group and grouping includes four medications.  Their trade names are “Aricept” , “Cognex” , “Excelon”  and “Reminyl”.  This group of medications , specifically the  “Cholinterase Inhibitors”   work via a mechanism of raising brain levels of the chemical neurotransmitter in the brain , acetylcholine , that is deficient in people and patients who exhibit the signs , symptoms and progression of Alzheimer’s Disease and its variants.

It can be said that overall these drugs , and this classification of medications , work to slow the progression of Alzheimer’s Disease.

In terms of side effects , and the range and variations of side effects with the Cholinesterase classification of drugs  side effects are all pretty similar in their type and range.  This generally includes , nausea , vomiting ,diarrhea , stomach pain, and loss of appetite.  However care must be exhibited with the drug / medication Cognex which can work to effect and cause liver toxicity and toxicities.

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