dihydroergotoxine and Alzheimer-Disease

Topics: Adrenocorticotropic Hormone; Alzheimer Disease; Choline; Dementia; Dihydroergotoxine; Humans; Narcotic Antagonists; Peptide Fragments; Phosphatidylcholines; Physostigmine; Piracetam; Pyrrolidines; Succinimides

Topics: Alzheimer Disease; Animals; Brain; Dementia; Dihydroergotoxine; Humans; Models, Biological; Neurotransmitter Agents; Rats

No class of presently available drugs is able to alleviate the cognitive deficits which accompany senile dementia. The present article critically reviews the strategies which have until now been used to treat these deficits. A description is given of the cognitive deficits which are commonly seen and of the cerebral substrate underlying memory processes. Furthermore, the various treatment strategies are critically reviewed as well as the rationale behind the use of the currently available drugs. It is concluded that no clinically significant improvement of cognitive disturbances can be obtained with the present available drugs. The neuropeptide strategy however may reveal new pharmacotherapeutic possibilities in the near future.

Topics: Adrenocorticotropic Hormone; Aged; Alzheimer Disease; Anticonvulsants; Brain; Catecholamines; Choline; Dementia; Dihydroergotoxine; Humans; Memory Disorders; Narcotic Antagonists; Nerve Tissue Proteins; Neuropsychology; Parasympatholytics; Phosphatidylcholines; Physostigmine; Piracetam; Trace Elements; Vasopressins; Vitamins

Ergoloid mesylates has been used for 30 years to treat patients with senile dementia. Indications for this drug include hypertension, peripheral vascular disease, and senile dementia of the Alzheimer type. Formerly classified as a cerebral vasodilator, ergoloid mesylates is now considered a metabolic enhancer, but how this action pertains to treatment of senile dementia is uncertain. Prescribed doses of the drug range from 1.5 mg/d to as much as 12 mg/d, but the optimal dose is unknown. Although there is evidence of the short-term efficacy of ergoloid mesylates from numerous controlled trials, many clinicians still consider it to be a placebo. No alternative drug treatments have been proved better. The crucial decision a physician must make is whether to try specific drug therapy or rely solely on supportive care and symptomatic drug treatment. The increasing prevalence of senile dementia has renewed interest in discovering more effective drug treatments for this condition.

Topics: Alzheimer Disease; Animals; Brain; Cerebrovascular Circulation; Clinical Trials as Topic; Dementia; Dihydroergotoxine; Drug Administration Schedule; Drug Utilization; Europe; Humans; United States; Vasodilator Agents

Topics: Adult; Age Factors; Aged; Alzheimer Disease; Amphetamine; Antidepressive Agents, Tricyclic; Dementia; Depression; Dihydroergotoxine; Female; Humans; Male; Memory; Methylphenidate; Papaverine; Procaine; Pyrrolidinones; Thioridazine

There is no effective pharmacologic treatment for Alzheimer's disease, the most common dementing illness in the United States. Hydergine, a combination of ergoloid mesylates, is the only approved medication for Alzheimer's disease, but despite widespread use its efficacy remains to be established. We conducted a clinical trial of Hydergine-LC, a newer preparation of ergoloid mesylates in the form of a liquid in a capsule (LC) that may have greater bioavailability, to determine its value in patients with Alzheimer's disease.. Eighty older adults with probable Alzheimer's disease participated in this double-blind, placebo-controlled trial of Hydergine-LC for 24 weeks. The recommended dose of 1 mg orally three times daily was used. Cognition and behavior were evaluated before and after the trial, and the patients were monitored for adverse effects. The medication was safe and well tolerated. The Hydergine-LC group did not perform better after treatment than the placebo group on any test, and its performance was worse (P less than 0.01 and P less than 0.02, respectively) on one cognitive measure (Wechsler Adult Intelligence Scale Digit Symbol Substitution Task) and on one behavioral scale (the Geriatric Evaluation by Relatives Rating Instrument).. Hydergine-LC appears to be ineffective as a treatment for Alzheimer's disease.

Topics: Aged; Alzheimer Disease; Biological Availability; Capsules; Clinical Trials as Topic; Dihydroergotoxine; Double-Blind Method; Female; Humans; Intelligence Tests; Male; Middle Aged; Psychiatric Status Rating Scales; Wechsler Scales

Topics: Aged; Alzheimer Disease; Cognition Disorders; Dihydroergotoxine; Double-Blind Method; Humans; Middle Aged

A 10-week placebo-controlled double-blind crossover protocol of combination therapy with lecithin and ergoloid mesylates was conducted in seven patients with presenile and senile dementia, Alzheimer's type. The patients' abilities to detect spatial arrangements, to recognize faces, and to identify new words on the Delayed Recognition Span Test were not significantly improved. Dementia Rating Scale scores before treatment were not significantly different from those after treatment.

Topics: Aged; Alzheimer Disease; Ambulatory Care; Dihydroergotoxine; Double-Blind Method; Drug Therapy, Combination; Humans; Middle Aged; Phosphatidylcholines; Psychiatric Status Rating Scales; Psychological Tests

Ergoloid mesylates has been used for 30 years to treat patients with senile dementia. Indications for this drug include hypertension, peripheral vascular disease, and senile dementia of the Alzheimer type. Formerly classified as a cerebral vasodilator, ergoloid mesylates is now considered a metabolic enhancer, but how this action pertains to treatment of senile dementia is uncertain. Prescribed doses of the drug range from 1.5 mg/d to as much as 12 mg/d, but the optimal dose is unknown. Although there is evidence of the short-term efficacy of ergoloid mesylates from numerous controlled trials, many clinicians still consider it to be a placebo. No alternative drug treatments have been proved better. The crucial decision a physician must make is whether to try specific drug therapy or rely solely on supportive care and symptomatic drug treatment. The increasing prevalence of senile dementia has renewed interest in discovering more effective drug treatments for this condition.

Topics: Alzheimer Disease; Animals; Brain; Cerebrovascular Circulation; Clinical Trials as Topic; Dementia; Dihydroergotoxine; Drug Administration Schedule; Drug Utilization; Europe; Humans; United States; Vasodilator Agents

The present study provided a neuropsychological assessment of impaired attention in Alzheimer's patients (57-89 years of age). Three control groups were evaluated: young normals (ages 18-32 years of age), an older group (55-69 years of age), and an elderly group (70-85 years of age). Alzheimer's patients showed an absence of CNV rebound and impairment in attention performance. They also showed significantly less facilitation in speed of response by a preparatory signal than the non-patient groups. These findings suggested a possible discontinuity between normal aging and Alzheimer's disease. On the other hand, a comparison of young, normal elderly, and Alzheimer's groups indicated a pattern of systematic decrease in CNV rebound, lowered short-term memory performance, and slowing of reaction time during divided-attention, a finding that suggests normal aging and senile dementia to represent quantitative differences on a continuum of gradual age-related deterioration. Alzheimer's patients showed elevated levels of basal heart rate and eyeblink rate and increased oculomotor responsiveness in divided-attention conditions. This finding was interpreted as compelling evidence against the concept of hypoactivity in senile dementia and as support for a distraction-arousal interpretation of impaired attention in Alzheimer's patients, although decreased basal myogenic activity and lowered heart rate levels during divided attention in the patients indicated selectively dampened psycho-physiological functioning. Distraction-arousal processes appeared to be curtailed in the patient group after Hydergine treatment.

Topics: Adult; Aged; Aging; Alzheimer Disease; Attention; Blinking; Cognition; Dihydroergotoxine; Double-Blind Method; Electroencephalography; Heart Rate; Humans; Middle Aged

The efficacy of antidemential agents proven in comprehensive studies and by clinical experience, now justifies an active and positive approach by the general physician to the diagnosis and treatment of patients with dementia. The proposals on how to implement diagnostic and therapeutic measures in the doctor's office comply both with medical quality criteria and the requirements for appropriateness of treatment and considerations of economy stipulated by German law. They therefore provide the basis for a modern diagnostic work-up and treatment strategy, which will also meet economical demands.

Topics: Aged; Alzheimer Disease; Brief Psychiatric Rating Scale; Carbamates; Cholinesterase Inhibitors; Dihydroergotoxine; Donepezil; Family Practice; Female; Follow-Up Studies; Galantamine; Ginkgo biloba; Humans; Indans; Male; Memantine; Neuroprotective Agents; Nimodipine; Nootropic Agents; Phenylcarbamates; Piperidines; Piracetam; Psychiatric Status Rating Scales; Risk Factors; Rivastigmine; Time Factors; Vasodilator Agents

Topics: Alzheimer Disease; Dihydroergotoxine; Humans

Topics: Aged; Alzheimer Disease; Antidepressive Agents; Antipsychotic Agents; Brain; Dementia; Diagnosis, Differential; Dihydroergotoxine; Female; Humans; Male; Middle Aged; Naloxone

Topics: Aged; Alzheimer Disease; Brain; Dihydroergotoxine; Dopamine; Female; Humans; Middle Aged; Prolactin; Reaction Time

The cerebrospinal fluid level of homovanilic acid (HVA), 5 hydroxyindolacetic acid (5HIAA) and 3 methoxy-4-hydroxy phenylglycol (MHPG) was determined twice at 12 to 15-day intervals in 23 patients with Alzheimer-type dementia (ATD). No correlation was found with the degree of dementia as assessed by psychometric testing. In most of the patients, the CSF levels of 5HIAA, MHPG and to a lesser extent HVA were found to be rather stable within a period of 2 weeks. The observation of a decrease in the concentration of HVA but not of 5HIAA or MHPG in 10 out of 12 patients treated with ergoloid mesylate may therefore be of interest in elucidating the mechanism of action of this drug in ATD.

Topics: Aged; Alzheimer Disease; Dihydroergotoxine; Female; Homovanillic Acid; Humans; Hydroxyindoleacetic Acid; Male; Methoxyhydroxyphenylglycol; Middle Aged; Neurotransmitter Agents; Psychometrics

Topics: Acetylcholine; Aged; Aging; Alzheimer Disease; Brain; Choline; Choline O-Acetyltransferase; Dihydroergotoxine; Humans; Memory Disorders; Neurotransmitter Agents; Phosphatidylcholines

Topics: Aged; Alzheimer Disease; Dementia; Dihydroergotoxine; Humans; Nafronyl; Papaverine; Pentoxifylline; Piracetam; Procaine; Psychotropic Drugs

Topics: Aged; Alzheimer Disease; Cerebrovascular Circulation; Dementia; Dihydroergotoxine; Humans

Topics: Aged; Alzheimer Disease; Amnesia; Dihydroergotoxine; Humans; Prognosis

The effect of DH-ET (dihydroergotoxine = 33% DH-ergocornine (DH-ECO) + 33% DH-ergocristine (DH-ECS) + + 33% DH-ergokryptine (DH-alfa-ECP: DH-beta-ECP = 2:1 and that of the single DH-derivatives on the retention of 14C-uridine (14C-U) in three parts of the brain tissue, blood plasma and liver tissue was estimated (i.e. radioactivity four hours after ip. adm. of 74kBq X 100 g-1). In young male rats DH-ET and DH-ECO enhanced the retention of 14C-U especially in the parietal cortex In one year old males DH-ECS and DH-alfa-ECP had the greatest effect. As a model of undesired effects the influence on peripheral blood flow in the hind limb of urethanised rats was examined using the perfusion' technics. All substances in the dose of 1 microgram removed epinephrine induced vasoconstriction although they themselves in the dose of 100 micrograms enhanced the perfusion pressure, excepting DH-ECO. All substances diminished the liver blood pool in urethanised rabbits (as norepinephrine does), most efficient being DH-beta-ECP and DH-ECO. On the other hand these substances also slowed the velocity of blood stream. The highest toxicity (LD) of DH-ECS and the lowest one of DH-alfa-ECP was found by an infusion technique. All substances diminished heart frequency but had a variable effect on PQ and QT ECG intervals. Ranging all substances according to their desirable properties from the geriatric viewpoint an index for each substance was calculated. This was most advantageous in the case of DH-alfa-ECP and DH-ECS in contrast to DH-ET and DH-ECO.

Topics: Alzheimer Disease; Animals; Cerebral Cortex; Cerebrovascular Disorders; Chinchilla; Dihydroergotoxine; Ergot Alkaloids; Humans; Liver; Male; Mice; Neurocognitive Disorders; Rats; Uridine; Vasoconstriction

Topics: Alzheimer Disease; Animals; Brain; Cerebrovascular Circulation; Combined Modality Therapy; Dementia; Depressive Disorder; Dihydroergotoxine; Double-Blind Method; Energy Metabolism; Humans; Meclofenoxate; Neurotransmitter Agents; Piracetam; Psychotherapy; Pyrithioxin

Topics: Aged; Alzheimer Disease; Dementia; Dihydroergotoxine; Dose-Response Relationship, Drug; Female; Humans; Male

Topics: Aged; Alzheimer Disease; Dementia; Dihydroergotoxine; Humans; Middle Aged; Research

Topics: Alzheimer Disease; Dementia; Dihydroergotoxine; Humans