Noradrenergic drugs, often prescribed for hypotension and attention deficit hyperactivity disorder, may be an effective treatment for Alzheimer’s disease, researchers report today.
Dr Michael David of Imperial College London, UK, and colleagues explain in The Journal of Neurology Neurosurgery & Psychiatry today that noradrenergic dysfunction partly drives early Alzheimer’s disease symptoms.
They write that the noradrenergic system "offers a potential therapeutic target, although noradrenergic treatments are not currently used in clinical practice".
So, the team searched research databases and found 19 reliable trials. A meta-analysis of ten of the studies, covering 1,300 patients, showed" a significant small positive effect of noradrenergic drugs on global cognition".
The drugs also improved measures of apathy but did not appear to significantly improve attention.
"Apathy is a common and prognostically adverse feature of Alzheimer’s disease," the team reports. "Although the apathy analysis only included 425 patients, it was particularly robust."
Methylphenidate was the most frequently tested medication for apathy in the studies.
The authors add: "Repurposing of established noradrenergic drugs is most likely to offer effective treatment in Alzheimer’s disease for general cognition and apathy."
They believe there is "a strong rationale for further, targeted clinical trials of noradrenergic treatments in Alzheimer’s disease” but point out that clinical trials should select patient subgroups carefully and examine the effects of individual drugs and their interactions with other treatments.
David, M. C. B. et al. Cognitive and neuropsychiatric effects of noradrenergic treatment in Alzheimer’s disease: systematic review and meta-analysis. Journal of Neurology Neurosurgery & Psychiatry 6 July 2022; doi: 10.1136/jnnp-2022-329136
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