Combination treatment reduces agitation for patients with probably Alzheimer

The drug is approved to treat pseudobulbar affect, a condition present in some neurodegenerative disorders that is marked by uncontrollable bouts of laughing or crying.

New research suggests that the combination treatment dextromethorphan hydrobromide-quinidine sulfate can help reduce agitation in people with probable Alzheimer disease.

“We conducted the trial for AVP923, this is the drug’s number, and showed that patients that received the drug had a statistically significant reduction in their agitation”, explained Dr. Cummings.

In a multi-site study of 220 patients diagnosed with probable AD according to 2011 NIA-AA criteria, treatment roughly halved the severity of agitation as measured by the Neuropsychiatric Inventory Agitation/Aggression scale.

The study tested the drug AVP-923 in participants with Alzheimer’s disease and moderate-to-severe agitation over a 10-week period.

In this group, active treatment resulted in a reduction in the average score from 5.8 to 3.8, which was significantly greater than the 6.7 to 5.8 change associated with continued placebo, the team reports in JAMA.

Treatment differences between the dextromethorphan-quinidine and placebo groups were significant in stage 1 (P .001) and stage 2 (P =.02). Serious adverse events occurred among 7.9% of individuals who received dextromethorphan-quinidine and 4.7% of those who received placebo. Almost 9 percent of those who took it had a fall and about 5 percent developed a urinary tract infection. At that point, 59 patients who were showing no response to the placebo pills were started on dextromethorphan-quinidine; another 60 remained on the placebo.

“Within this clinical treatment environment, pending further evidence, there is a reasonably strong case to prioritize dextromethorphan-quinidine as an off-label treatment for agitation, possibly as a safer alternative to atypical antipsychotics”, they say. “It’s important to remember that these are early results”, she said. In addition, the study was too short to demonstrate any improvement to quality of life. The authors also disclosed relationships with Avid Radiopharmaceutical, Teva Pharmaceuticals, AbbVie, Acadia, ADAMAS, Alzheon, Anavex, AstraZeneca, Avanir, Biogen-Idec, Biotie, Boehringer-Ingelheim, Chase, Eisai, Forum, Genetech, Grifols, Intracellular Therapies, Lilly, Lundbeck, Merck, Neurotrope, Novartis, Nutricia, Otsuka, Pfizer, Prana, QR Pharma, Resverlogix, Roche, Sonexa, Suven, Takeda, Toyoma, GE Healthcare, MedAvante, Neurotrax, Neurokos, Forest, GlaxoSmithKline, Pfizer, Ortho-McNeil, Bristol-Myers Squibb, Novartis, Elan and Functional Neuromodulation, Supernus, Adlyfe, Wyeth, Lundbeck, Merz, Genentech, and Zinfandel.