A new drug, galantamine, may slow the progression of cognitive decline in Alzheimer's patients, according to a study published in the December 9, 2000 British Medical Journal.

Over a period of six months, 653 patients in Europe and Canada with mild to moderate Alzheimer's disease received either galantamine or a placebo. The doses of galantamine were increased gradually over the period of the study.

The effectiveness of the drug was measured by the participants' scores on the cognitive sections of the Alzheimer's disease assessment scale, the disability section of the dementia test, and interviews with participants and their caregivers.

Evaluations of participants on galantamine improved, especially at higher doses. Although most participants tolerated galantamine well, some experienced nausea and vomiting, especially at the higher doses.

Galantamine is not commercially available in the United States, but approval by the Food and Drug Administration is anticipated by the end of 2001. The U.S. brand name of galantamine will be Reminyl. In other countries, galantamine's brand name is Nivalin.

Galantamine may offer one more medication that patients with mild to moderate Alzheimer's disease may try. Slowing the progression of Alzheimer's disease results in improved patient self-esteem and fewer demands made on caregivers.

Over-the-counter pain relievers such as Advil and Motrin appear to protect against Alzheimer's disease by thwarting production of a protein found in the disease's brain-clogging deposits.

Since 1997, scientists have noted that some people who regularly take large amounts of ibuprofen and other nonsteroidal anti-inflammatories, or NSAIDs, run a lower risk of developing Alzheimer's disease.

Researchers said the findings could lead to treatments that reduce the formation of brain deposits, or plaques, without toxic side effects.

"If the findings can be extended to people, these drugs could join the Ivy League of potential treatments" for Alzheimer's, said biologist Bart De Strooper of the Catholic University of Leuven, Belgium. The findings were published in an issue of Nature.

Researchers had thought that NSAIDs protected against Alzheimer's by reducing inflammation. Instead, the new study shows that the drugs inhibit production of certain protein, amyloid-beta 42, that is found in the tangled plaques that clog and kill the brain cells of Alzheimer's victims.

"Our study provides the first explanation as to why nonstroidals may be working in Alzhiemer's disease," said Dr. Edward Koo, a neurologist at the University of California-San Diego who led the study.

Koo and others warned that doctors should not prescribe high doses of NSAIDs to prevent Alzheimer's. The doses used in the experiments were equal to more than 16 Advils a day, far more than what is recommended.

NSAIDs can cause life-threatening kidney damage and severe gastrointestinal ailments in high doses. Also, the potential benefits remain poorly understood.

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