HomeLifestyleHealth & FitnessA drug for constipation, promising as a memory treatment

A drug for constipation, promising as a memory treatment

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A team of researchers discovered that an existing medicine – used to treat constipation – may be able to increase our ability to think more clearly, bringing the creation of drugs to treat cognitive issues in individuals with mental illness one step closer.

Severe psychiatric diseases can have a life-changing influence on a patient. Cognitive deficits are common in mental diseases such as major depression, schizophrenia, and bipolar disorder, ranging from impaired attention and working memory to disordered social cognition and language.

These common issues are inadequately addressed by present pharmaceuticals and frequently have a significant impact on people’s lives, thus scientists are looking for ways to improve or restore these functions.

Previous animal studies have demonstrated that medications that target one of the serotonin receptors (the 5-HT4 receptor) have the potential to improve cognitive performance (serotonin is the neurotransmitter that is targeted by SSRI antidepressants).

However, due to concerns about side effects, it has been difficult to convert these animal findings into human studies.

A group of UK researchers has now examined an already approved medicine, prucalopride, which targets the 5-HT4 receptor, and discovered that it may boost cognition. Prucalopride is primarily used to treat constipation and has a low risk of side effects when used under medical care.

The trial included 44 healthy volunteers ranging in age from 18 to 36. Prucalopride was administered to 23 people, while a placebo was given to 21 people. After 6 days, all volunteers underwent an fMRI brain scan. Volunteers were given a sequence of photos of animals and landscapes before entering the MRI machine.

During the scan, they looked at the same photos again, as well as others of a similar nature. Following the scan, subjects were asked to perform a memory test in which they had to recognize the images they had seen before and during the scan from a set of completely new images.

While presenting the work at the congress of the European College of Neuropsychopharmacology, held in Lisbon, the main researcher, Dr. Angharad de Cates, from the University of Oxford, explained that “Participants who had taken prucalopride for 6 days performed much better than those receiving placebo on the memory test; the prucalopride group identified 81% of previously viewed images versus 76% in the placebo group”.

“Statistical tests indicate that this was a fairly large effect – such an obvious cognitive improvement with the drug was a surprise to us,” he admits.

The researchers found that, compared to those taking the placebo, the volunteers taking prucalopride were significantly better on the memory test after the scan, and they also had fMRI scans that indicated greater activity in brain areas related to cognition.

The increased activity occurred in areas associated with memory, such as the hippocampus (in the center of the brain) and the right angular gyrus (towards the back of the brain).

Dr Susannah Murphy, lead researcher at the University of Oxford and lead author of the study, stresses that “even when the low mood associated with depression is well treated with conventional antidepressants, many patients continue to experience problems with their memory. Our study provides exciting early evidence in humans of a new approach that might be a helpful way to treat these residual cognitive symptoms”.

Angharad de Cates notes that “this is a proof-of-concept study, and so a starting point for further investigation. We are currently planning and undertaking further studies looking at prucalopride and other 5HT4 agonists in patient and clinically vulnerable populations, to see if our findings in healthy volunteers can be replicated and have clinical importance”.

Prucalopride is a 5-HT4 agonist that is primarily used to treat constipation. It has no significant side effects when taken under medical supervision, though doctors warn of the possibility of headache, gastro-intestinal symptoms such as abdominal pain, nausea, and diarrhoea, and fatigue or dizziness; none of the volunteers taking prucalopride in this study experienced any significant side effects.

Source: European College of Neuropsychopharmacology

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