Sunday January 26, 2020

Research Finds That Drug Can Curb Dementia’s Delusions

About 8 million Americans have dementia, and studies suggest that up to 30% of them develop psychosis.

0
//
Television actor Barbara Windsor and her husband Scott Mitchell talks about Drugs
Television actor Barbara Windsor and her husband Scott Mitchell pose with a placard in front of Downing Street ahead of a meeting with Britain's Prime Minister Boris Johnson in London, Britain. VOA

A drug that curbs delusions in Parkinson’s patients did the same for people with Alzheimer’s disease and other forms of dementia in a study that was stopped early because the benefit seemed clear.

If regulators agree, the drug could become the first treatment specifically for dementia-related psychosis and the first new medicine for Alzheimer’s in nearly two decades. It targets some of the most troubling symptoms that patients and caregivers face — hallucinations that often lead to anxiety, aggression, and physical and verbal abuse.

Results were disclosed Wednesday at a conference in San Diego.

Unmet need for treatment

“This would be a very important advance,” said one independent expert, Dr. Howard Fillit, chief science officer of the Alzheimer’s Drug Discovery Foundation.

Although the field is focused on finding a cure for dementia and preventing future cases, “there is a huge unmet need for better treatment” for those who have it now, said Maria Carrillo, the Alzheimer’s Association’s chief science officer.

The drug is pimavanserin, a daily pill sold as Nuplazid by Acadia Pharmaceuticals Inc. It was approved for Parkinson’s-related psychosis in 2016 and is thought to work by blocking a brain chemical that seems to spur delusions.

Dementia Drugs
Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. Pixabay

About 8 million Americans have dementia, and studies suggest that up to 30% of them develop psychosis.

“It’s terrifying,” said Dr. Jeffrey Cummings of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. “You believe that people might be trying to hurt you. You believe that people are stealing from you. You believe that your spouse is unfaithful to you. Those are the three most common false beliefs.”

How the study worked

He consults for Acadia and helped lead the study, which included about 400 people with dementia and psychosis. All were given a low dose of the drug for three months, and those who seemed to respond or benefit were then split into two groups. Half continued on the drug and the others were given dummy pills for six months or until they had a relapse or worsening of symptoms. Neither the patients nor their doctors knew who was getting what.

Independent monitors stopped the study when they saw that those on dummy pills were more than twice as likely as those on the drug to relapse or worsen — 28% versus nearly 13%.

There were relatively few serious side effects — 5% in the drug group and 4% in the others. Headaches and urinary tract infections were more common among those on the drug. Two deaths occurred, but study leaders said neither was related to the drug.

The drug could become the first treatment for dementia
The drug could become the first treatment specifically for dementia-related psychosis. Pixabay

Carrillo said the study was small, but the drug’s effect seemed large, and it’s not known whether the federal Food and Drug Administration would want more evidence to approve a new use.

Risk of death

Current anti-psychotic medicines have some major drawbacks and are not approved for dementia patients.

“They’re often used off label because we have very few other options,” Fillit said.

ALSO READ: Researchers Associate Social Media Use to Eating Disorder in Adolescents

All carry warnings that they can raise the risk of death in elderly patients, as does Nuplazid.

Cost could be an issue — about $3,000 a month. What patients pay can vary depending on insurance coverage. (VOA)

Next Story

How Do Drugs Impact Anxiety Disorder?

Anxiety disorders are a fact of life for many

0
Disorder
Anxiety disorder is a fact of life for many. It occurs when the body’s normal response to stress becomes out of hand, and it begins to produce an anxiety response to harmless situations.  Pixabay

What is anxiety?

Anxiety Disorder is a completely normal response to perceived threats to your wellbeing. Whether it be a driving test, difficult exam or job interview, these are all situations which can commonly be labelled as ‘stressful’.

Any stressor can lead to anxiety, which is best described as an unpleasant feeling of intense fear. Regular levels of anxiety accompanying a stressful situation is a completely normal bodily reaction, but anxiety often morphs into disorders which can be hard to overcome. 

Anxiety disorders are a fact of life for many. These occur when the body’s normal response to stress becomes out of hand, and it begins to produce an anxiety response to harmless situations. 

A couple of examples of anxiety disorders include:

    • Social anxiety disorder. This is defined by a strong anxiety triggered by social situations, particularly ones such as talking in groups, talking to unfamiliar people or giving a speech. The root fear is being judged negatively by others in social situations. 

 

  • Phobias. Phobias are classified as anxiety disorders, as they consist of an extreme fear response to a particular stimuli. A common phobia is arachnophobia, extreme anxiety and fear caused by spiders. 

 

As seen from the examples, anxiety disorders are often centred around stimuli which are not anxiety-provoking for the whole population. That is the key when it comes to disorders.

What can we do to reduce anxiety?

There are multiple common remedies for anxiety, including the following:

  • Therapy, such as cognitive behavioural therapy (CBT).
  • Mindfulness and meditation.
  • Exercise.
  • low carb diets can be anti-inflammatory and in some cases decreases neuro-psychiatric symptoms.
  • Drug-related intervention, from herbal teas and cannabidiol oil to prescription medication like Prozac.. 

The final bullet is the one that we will focus on in this article, as want to gauge how drugs impact anxiety levels, and the testing which has gone into this.

Natural remedies including lifestyle changes such as exercise are often suggested as remedies for mild anxiety. Therapy is often suggested if anxiety becomes a real problem in someone’s life.

There is also a sliding scale of drug-related solutions. Herbal tea could be used to cure mild anxiety, whereas somebody would be prescribed medication like Prozac if their anxiety is severe.

How are drugs used to treat anxiety?

Different medication is prescribed depending on the severity of anxiety. For example, antidepressants and SSRIs such as Prozac, Zoloft and Paxil would only be administered if a patient was suffering from chronic anxiety. In this case, the drugs act on the brain’s neural pathways to alter the way in which the neurotransmitter serotonin is used. 

Alternatively, antihistamines and beta-blockers are often recommended for more mild cases of anxiety. Rather than being taken daily in order to restructure the brain’s behavior, these are usually taken when anxiety occurs or before an anxiety-producing event.

For immediate relief of more acute anxiety, benzodiazepines such as diazepam and clonazepam are usually taken. However, these often receive bad press for their side effects which can include drowsiness, irritability and a physical dependence on the drug. 

How do we find out which anti-anxiety drugs are safe for human use? Ethical animal testing is often the answer.

Anxiety, Fear, Stress, Emotion, Wooden
Anxiety is a completely normal response to perceived threats to your wellbeing. Whether it be a driving test, difficult exam or job interview, these are all situations which can commonly be labelled as ‘stressful’. Pixabay

Testing for anti-anxiety solutions, particularly in rodents

Rodents are often used in scientific experiments which aim to identify new treatments for anxiety in humans. Considering the relative similarities of key brain structures, we can observe the effects of anxiety-provoking situations on rodents to know which parts of the brain could be involved in anxiety responses.

Lezak, 2017, provides excellent discussion on the testing of rodents for anxiety-like symptoms. He describes the stimuli we provide as ‘assays’, rather than ‘models’. By definition, a model is required to have extreme detail and be thoroughly tested. 

One assay commonly used for anxiety measurement in rodents is the Open Field Test. This really is a basic test, involving a box in which a rodent is placed. The box is lined with tall walls which can be set to either clear or opaque. 

Typically, a rodent feeling more anxiety-like would tend to stick close to the walls of the box, and venture out into the middle very little. Conversely, a ‘happy’ rodent would be explorative, and spend time in the open space in the middle of the box. It is also possible to analyze other behaviors of the rodent such as rearing, grooming and freezing, to judge its levels of confidence in its surroundings.

A simple study into measuring the effects of drugs on rodents in an Open Field Test would be to administer a benzodiazepine and record the difference in anxiety-like behaviors. There have been studies which confirm the reduction in rodent anxiety-like behaviors after administering a benzodiazepine, but which also report other changes in behavior such as shifts in locomotor pattern.

Any unexpected or additional effects which drugs have on rodents must be seriously considered before a drug is approved for human usage.

Can drugs also contribute to anxiety negatively?

So far, we have covered the ways in which drugs can be used to treat anxiety. However, it is also true that certain drugs can worsen the symptoms of anxiety.

Substance-induced anxiety disorders are the name given to anxiety, panic and fear caused by the taking of a drug, or stopping taking a drug. 

Alcohol, as well as illegal drugs such as cocaine and LSD can be responsible for substance-induced anxiety disorders. This may be because of thoughts associated with the use of the drugs: “I’m worried that I’m too dependent on this drug”, “I know that if I stop taking this drug, my anxiety levels will go through the roof”. 

As well as fear caused by the drug, there are other symptoms like insomnia, memory loss and difficulty breathing which can all contribute to increased anxiety levels after taking these drugs.

Abuse of stimulants and steroids in particular will cause a pounding, irregular heartbeat and racing thoughts. 

In short, misusing any type of drug can lead to substance-induced anxiety disorders. If you already suffer from anxiety, the best course of action is to consult a doctor and take the drugs recommended to you, in their recommended doses.

Anxiety, Stress, Depression, Mental Health, Loneliness
anxiety disorders are often centred around stimuli which are not anxiety-provoking for the whole population. That is the key when it comes to disorders. Pixabay

The power of drugs on our mental wellbeing

It is clear that drugs have the capacity to affect our mental state in both positive and negative ways. In particular, anxiety is a symptom easily influenced by psychoactive drugs. 

Understanding exactly what anxiety is, as well as knowing which types of drugs fit each severity level, will go a long way to fighting this disruptive mental disorder off. 

ALSO READ: Promotional E-Cigarettes Posts on Instagram Outnumber Anti-Vaping Content: Study

Author bio: 

Shuhan He is a physician and scientist, founder of ConductScience.com – a company that creates translational science tools for outcomes in science. The aim of the company is to improve the scientific community by making it easier to access top-quality scientific equipment.

He also works as an emergency medicine physician at the Massachusetts General Hospital.