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Drugs for Alzheimer's Disease Being Considered; Help for Nail Infections | |
| By DR. MICHAEL L. FREEDMAN Associated Press NEW YORK - Help is on the way for Alzheimer's patients. At present, only one drug is approved for treatment of this mind-stealing disease, which afflicts an estimated 4 million older Americans. Use of that drug, Cognex, is based on the knowledge that Alzheimer's disease destroys brain cells that communicate with other brain cells via a chemical called acetylcholine. Cognex improves brain function by preventing the destruction of acetylcholine. But it has only limited effectiveness and can have severe side effects. Another drug that works the same as Cognex is awaiting approval by the Food and Drug Administration. And there is active research to develop a number of different drug treatments. The anti-Alzheimer's drugs now in various stages of development and testing include ordinary vitamin E, as well as anti-inflammatory compounds such as prednisone - widely used to treat arthritis - and the female hormone, estrogen. Vitamin E is believed to slow the progression of Alzheimer's disease by preventing the destruction of brain cells by chemicals called oxygen-free radicals, which are made in the brain. The anti-inflammatory drugs are believed to protect brain cells against damage or destruction caused by inflammation. It's been noted that during menopause, when the body's estrogen production ceases, women seem to be more vulnerable to Alzheimer's than men. Giving estrogen is believed to help Alzheimer's patients by promoting the growth of the projections that nerve cells use to communicate with each other. Also being tested against Alzheimer's disease are calcium-channel blockers and cholesterol-lowering medications, now used for heart disease. Laboratory tests have shown such drugs prevent brain cell damage caused by calcium and another body chemical, apoE4. It will take a while to collect evidence on whether all - or any - of these drugs will work. But the very fact that there are so many Alzheimer's research programs using so many different approaches is a sign of hope. --- And help is here for the fingernail and toenail infection called onyochmycosis, which is especially common among older people. About a third of people aged 60 to 70 are afflicted with onychomycosis, and the infection rate is nearly 50 percent after the age of 70, a new survey has found. Many patients say they cannot wear shoes or work with their hands because of the infection. Until recently, there was no effective treatment for the condition. Now two new antifungal drugs have been approved by the Food and Drug Administration. They are itraconazole, brand name Sporanox, and terbinafine, brand name Lamasil. A third drug, fluconazole, is awaiting approval. These drugs are taken orally. Studies have shown that they can significantly reduce or eliminate fungal nail infections when taken for 12 to 24 weeks. Their most common side effect is minor gastrointestinal upset; no major adverse effects have been reported. Physicians are evaluating the best course of treatment to maximize the effectiveness of the drugs. The encouraging news is that they provide help when none was available before. --- EDITOR'S NOTE - Dr. Michael L. Freedman is the Diane and Arthur Belfer Professor of Geriatric Medicine and Director of Geriatrics at New York University Medical Center. Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. | |