Nootropic drugs in Alzheimer's disease

Symptomatic treatment with pramiracetam

Claus, J. J. MD
Ludwig, C. MD
Mohr, E. PhD
Giuffra, M. MD
Blin, J. MD
Chase, T. N. MD

Experimental Therapeutics Branch (Drs. Claus, Ludwig, Giuffra, Blin, and Chase), National Institutes of Neurological Disorders and Stroke, Bethesda, MD; and the Neuropsychology Service, Royal Ottawa Hospital, and Faculty of Medicine (Dr. Mohr), University of Ottawa, ON, Canada.

Address correspondence and reprint requests to Dr. T.N. Chase, ETB/NINDS, Building 10, Room 5C103, 9000 Rockville Pike, Bethesda, MD 20892.

Presented in part at the 42nd annual meeting of the American Academy of Neurology, Miami Beach, FL, May 1990.

Received March 26, 1990. Accepted for publication in final form September 17, 1990.

Neurology 41(4):p 570-574, April 1991.

Article abstract

The cognitive-enhancing effects of pramiracetam in animal models of learning and memory are characterized by an inverted U-shaped dose-response curve. We evaluated antidementia efficacy of this drug in 10 patients with probable Alzheimer's disease employing a 2-phase, placebo-controlled, enrichment-type trial design. Eight patients evidenced a best dose in the dose-finding phase, but in the subsequent replication phase only two again improved to a similar degree. PETs with fluorodeoxyglucose obtained in two individuals showed no definite change. Doses up to 4,000 mg pramiracetam are unlikely to confer symptomatic benefit to Alzheimer's disease patients.