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Tacrine in Alzheimer's disease
S A Eagger1, R Levy, B J Sahakian
1Institute of Psychiatry, Denmark Hill, London, UK.
Lancet (London, England)
|April 27, 1991
Summary
Tacrine (tetrahydroaminoacridine) combined with lecithin significantly improved cognitive function in Alzheimer's disease patients, as measured by the MMSE and AMTS. While side effects like elevated liver enzymes were noted, the cognitive benefits were substantial.
Area of Science:
- Neuroscience
- Pharmacology
- Clinical Trials
Background:
- Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline.
- Tacrine (tetrahydroaminoacridine) is an acetylcholinesterase inhibitor investigated for AD treatment.
- Lecithin is a phospholipid supplement sometimes used adjunctively.
Purpose of the Study:
- To evaluate the efficacy and safety of tacrine plus lecithin in patients with probable Alzheimer's disease.
- To compare the effects of active treatment versus placebo using a randomized, double-blind, crossover design.
Main Methods:
- A randomized, double-blind, placebo-controlled, crossover study involving 89 patients with probable AD.
- Patients received either the maximum tolerated dose of tacrine (up to 150 mg/day) plus lecithin (10.8 g/day) or placebo for 13 weeks, followed by a 4-week washout and then crossover.
- Cognitive assessments included the Mini Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), and a carer's rating of Activities of Daily Living (ADL).
Main Results:
- Tacrine plus lecithin demonstrated a significant beneficial effect on MMSE scores compared to placebo (p < 0.0001), with 45% of patients showing improvement.
- Similar significant improvements were observed in AMTS scores (p = 0.0001).
- No significant treatment effect was found for the ADL score. Dose-dependent, reversible elevations in liver enzymes were common.
Conclusions:
- Tacrine plus lecithin offers a significant cognitive benefit in Alzheimer's disease patients, comparable to 6-12 months of slowed disease progression.
- The treatment showed a positive impact on key cognitive measures, though individual responses varied.
- While liver enzyme elevations are a concern, they were reversible, and the clinical relevance requires individual judgment.
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