There is “good evidence” that some of the drugs used to treat ADHD could also help with key symptoms of Alzheimer’s disease.
A pooled data analysis of available studies indicates “strong evidence” that meds to treat attention deficit hyperactivity disorder (ADHD) may also successfully treat key aspects of Alzheimer’s disease, according to a study published online in the Journal of Neurology, Neurosurgery, and Psychiatry.
Researchers say it’s time for clinical trials of noradrenergic drugs, which include antidepressants and medicines for high blood pressure and ADHD.
A network of specialized noradrenergic neurons emits the neurotransmitter noradrenaline, also known as norepinephrine.
This network is essential for wakefulness as well as numerous cognitive functions, such as suppression of improper behaviors, learning, memory, and readiness for action.
The noradrenergic system may be a useful target for pharmacological treatment since noradrenergic disruption occurs early in Alzheimer’s disease and contributes to the condition’s cognitive and neuropsychiatric symptoms.
Therefore, the researchers searched for clinical trials that used noradrenergic medications, such as atomoxetine, methylphenidate, and guanfacine, to possibly alleviate cognitive and/or neuropsychiatric symptoms in patients with neurodegenerative disease. These studies were published between 1980 and 2021.
They were 19 randomized control studies with 1811 patients that were specifically focused on Alzheimer’s disease and mild cognitive impairment. Six of these trials were rated as having “good” quality, seven as “fair,” and six as having “poor” quality.
The results of 10 of these trials, which involved 1300 patients, were put together to look at global cognition, including orientation/attention, memory, verbal fluency, language, and visual-spatial ability.
Using the Mini-Mental State Exam or the Alzheimer’s Disease Assessment Scale, showed that noradrenergic drugs had a small but significant effect on overall cognition.
The outcomes of 8 clinical trials including 425 individuals were then combined to assess behavior, agitation, and apathy. And even after removing outliers to account for variations in trial design and intended results, research showed a significant favorable effect of noradrenergic medications on apathy.
The researchers conclude that repurposing well-established noradrenergic drugs “is most likely to offer effective treatment in Alzheimer’s disease for general cognition and apathy”.
“There is a strong rationale for further, targeted clinical trials of noradrenergic treatments in Alzheimer’s disease,” they add.
However, they stress that a number of factors must be taken into account beforehand. These include effective targeting of certain patient groups and knowing the dose effects of individual medications and their combinations with other treatments in order to minimize the disadvantages and maximize the benefits of noradrenergic agents, according to the authors.
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