ADHD News & Research

Study: Alzheimer’s Symptoms May Improve with ADHD Medication

Alzheimer’s symptoms of slow cognition and apathy are positively affected by noradrenergic drugs, which do not improve attention or episodic memory, according to a new meta-analysis.

July 11, 2022

Alzheimer’s symptoms like slow cognition and apathy may improve in Alzheimer’s syndrome patients treated with ADHD medication, which has little effect on attention or episodic memory, according to a new study published in the Journal of Neurology, Neurosurgery & Psychiatry.1

The research, which comprised a meta-analysis of eight clinical trials involving 425 patients, found that ADHD medication had a significant positive effect on apathy, a common Alzheimer’s symptom. (The noradrenergic system influences motivation.)2

Findings from 10 studies involving 1,300 patients revealed a small positive effect of noradrenergic drugs on overall cognition, as measured by the Mini-Mental State Exam or the Alzheimer’s Disease Assessment Scale.1 However, the study reports that noradrenergic drugs do not significantly affect attention or episodic memory in patients with Alzheimer’s.

In assessing the efficacy of noradrenergic drugs in improving cognitive and neuropsychiatric symptoms in Alzheimer’s patients, the research team led by Dr. Michael David of the UK Dementia Research Institute identified 19 randomized, controlled trials conducted from 1980 to 2021. The trials included more than 1,800 participants aged 60 to 85 with Alzheimer’s disease or mild mental impairment who took noradrenergic drugs, such as atomoxetine (Strattera), methylphenidate (Ritalin or Concerta), and guanfacine (Tenex).

Researchers say the brain’s noradrenergic system may be a “good target for treatment because it is disrupted early in Alzheimer’s disease.”

The researchers recommend further clinical trials of ADHD medication in Alzheimer’s disease and other neurodegenerative conditions. “This meta-analysis suggests that drug repurposing with established noradrenergic treatments, such as atomoxetine, methylphenidate, and guanfacine, may benefit people with Alzheimer’s disease, particularly given existing evidence of their relative safety in clinical practice, and pharmacological target engagement,” researchers say.3

However, researchers recommend considering several factors, including “targeting of appropriate patient subgroups and understanding the dose effects of individual drugs and their interactions with other treatments to minimize risks and maximize therapeutic effects,” before designing future clinical trials.

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1David, M.; Del Giovane, M.; Liu, K. Y.; Gostick, B.; Rowe, J. B.; Oboh, I.; Howard, R.; & Malhotra, P. A. (2022). Cognitive and Neuropsychiatric Effects of Noradrenergic Treatment in Alzheimer’s Disease: Systematic Review and Meta-Analysis. Journal of Neurology, Neurosurgery, and Psychiatry, https://doi.org/10.1136/jnnp-2022-329136

2Holland, Negin; Robbins; Trevor W.; & Rowe, James B. (2021). The Role of Noradrenaline in Cognition and Cognitive Disorders. Brain, https://doi.org/10.1093/brain/awab111

3Levey, Allan I.; Qiu, Deqiang; Zhao, Liping; Hu, William T.; Duong, Duc M.; Higginbotham, Lenora; Dammer, Eric B.; Seyfried, Nicholas T.; Wingo, Thomas S.; Hales, Chadwick M.; Tansey, Malú Gámez; Goldstein, David S.; Abrol, Anees; Calhoun, Vince D.; Goldstein, Felicia C.; Hajjar, Ihab; Fagan, Anne M.; Galasko, Doug; Edland, Steven D.; Hanfelt, John; Lah, James J.; Weinshenker, David. (2022). A Phase II Study Repurposing Atomoxetine for Neuroprotection in Mild Cognitive Impairment. Brain, >https://doi.org/10.1093/brain/awab452

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