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November 25, 2004
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There may be new hope for Alzheimer’s patients.

As this ScienCentral News video reports, a German drug tested in the U.S. seems to slow down the disease in moderate to severely affected patients.

Drug Slows Down Alzheimer’s

Connie Costa, 68, used to work in accounting. But about four years ago she started having problems remembering things. She couldn’t remember what month or year it was and had problems writing even her name. Soon Connie was diagnosed with Alzheimer’s, a disease that affects about 4 million Americans, according to the Alzheimer’s Association, and about 10 percent of the population above 65 years of age.

“Alzheimer’s is a terrible and terribly prevalent disease”, says Barry Reisburg, clinical director of the Silberstein Aging and Dementia Treatment and Research Center at New York University School of Medicine. Experts estimate that in the coming years, as we live longer and as baby boomers get older, there is going to be a steep rise in the number of Alzheimer’s patients.

So far, there is no cure no known prevention for Alzheimer’s. Although there is some medication, Reisburg points out, “All currently approved medication has been shown to be effective only for mild and moderate Alzheimer’s.” But now Reisburg and his colleagues report in the New England Journal of Medicine that a German drug called Memantine could help patients in the more advanced stages of the disease.

Stages of Alzheimer’s

Like most Alzheimer’s patients, Connie Costa lost her memory first and then slowly started losing other brain functions as well. “In the course of Alzheimer’s”, Reisburg explains, “patients lose the abilities to carry out all basic capabilities. And they lose all their thinking abilities.” Gary Small, professor of aging at University of California Los Angeles’s Neuropsychiatric Institute, says that eventually Alzheimer’s patients, “need total care; they can’t even feed themselves.” This is the stage when the disease gets enormously challenging and demanding for the caregivers.

Connie’s husband, Donald Costa, is happy to help his wife. “Hey look,” he laughs, “she used to do everything. Now I do it. She took care of me all my life, right? That’s the way it is.” But caring for an Alzheimer’s patient isn’t easy. “Care-givers themselves get depressed and over-whelmed,” says Small.

Manufactured by Merz Pharmaceuticals, Memantine was found to help patients maintain some of their functional abilities longer, through the moderate to later stages of the disease. Reisburg and his colleagues evaluated the effectiveness of the drug in the United States. Merz Pharmaceuticals and the National Institute on Aging funded the study that involved 252 Alzheimer’s patients at 32 different centers throughout the country. Patients received either Memantine or a placebo (a “dummy” pill), twice a day for six months. At the end of six months, patients’ daily functioning and thinking capacities were tested. Reisberg’s team found that Memantine appeared to slow the progression of the disease by about 50 percent, in terms of both the loss of capacities of the Alzheimer’s patient and the loss of thinking abilities. Reisburg thinks Memantine will be “a breath of fresh air”—not only for patients, but also for caregivers.

How does Memantine work?

Nerve cells in the brain communicate via chemicals called neurotransmitters. When a nerve cell is damaged it produces an excess of one of these chemicals called glutamate. “The excess production of glutamate causes the receiving nerve to get over-excited. “And this over-excitability leads to damage and perhaps death of the receiving nerve,” explains Reisberg. “Memantine blocks one of the receiving stations in the receiving nerve—one of the docking stations for the chemical—and thereby blocks the over-excitability.” This prevents cell damage and death.

The U.S. Food and Drug Administration is currently reviewing the drug, and Reisburg is hopeful that the drug will be available for use in the U.S. within the next year.

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