Alzheimer's treatment helps some patients

PEOPLE'S PHARMACY

May 10, 1994|By Joe Graedon and Dr. Teresa Graedon | Joe Graedon and Dr. Teresa Graedon,King Features Syndicate

Last summer we almost drowned. We were swimming off Ocracoke Island, N.C., when we were swept up in a riptide. Hard as we tried, we couldn't seem to make any progress getting back to the beach.

Although there was no lifeguard on duty, two brave young men risked their own lives and pulled us out with their floats.

It's a good thing we didn't have to wait for the Food and Drug Administration to come to our rescue. The feds would have wanted to hold hearings, test the floats, certify their safety, and only then dip their toes in the surf.

Too many victims of Alzheimer's disease (AD) couldn't wait for the FDA. It took seven years for Cognex (tacrine or THA) to go through testing and approval for the treatment of this dread disease. Thousands of patients gradually lost their memories and their minds, and many ended up in nursing homes while the FDA deliberated. No one knows how many died.

In 1986, a preliminary report by Dr. William Summers appeared in the New England Journal of Medicine. For the first time, a drug seemed to offer benefit for those with AD.

Some families, encouraged by the news, gave their loved ones tacrine. Sometimes the results were impressive, with people regaining the ability to recognize grandchildren and friends. Activities of daily living, such as getting dressed, eating dinner and going to the bathroom, were no longer impossibly difficult.

When we wrote about these cases, we were scolded by the FDA for giving people false hope. The research going on at that time was in very low doses and did not offer much promise.

Now, word is in on high-dose Cognex therapy, and the results are positive. A recent study published in the Journal of the American Medical Association confirms Dr. Summers' discovery. Patients with mild or moderate AD taking 160 mg Cognex daily did measurably better than those on an inactive placebo.

Side effects discouraged some patients. Nausea, vomiting, diarrhea, loss of appetite, indigestion and stomachache were common, as were dizziness and headache. Often these symptoms were mild, but liver enzyme elevations prompted researchers to pull a number of patients out of the study. (The liver tests returned to normal after the drug was discontinued.)

Some people do improve dramatically while on Cognex. We have heard of instances where patients regained their sense of humor and others who could again use the telephone, ride a bicycle or read. Others do not benefit at all.

Although this drug is clearly not a cure for Alzheimer's disease, some families report it has allowed them to delay nursing home care. When you're drowning, any life raft is welcome.

A friend sent me a big newspaper ad about a new anti-aging pill. She had attached a brief note saying, "Try this, it works! R." I'm reluctant to buy pills that I can't just go to a pharmacy and get. The paper listed an address for ordering pills that they say work for arthritis, arteriosclerosis, senility and depression. Does any of this make sense to you?

You aren't the only one who received this ad in the mail. Several others contacted us, and we got one ourselves. They all had a Post-it Note with the same personalized message, "Try this, it works! R." This is slick advertising for a compound that has not been approved by the FDA for any of the advertised claims. Your caution is appropriate.

Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.

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