Bl. Flynn et Ae. Ranno, Pharmacologic management of Alzheimer disease part II: Antioxidants, antihypertensives, and ergoloid derivatives, ANN PHARMAC, 33(2), 1999, pp. 188-197
OBJECTIVE: To provide information about research evaluating antioxidants in
Alzheimer disease (AD) and to discuss the potential role of beta-blockers,
angiotensin-converting enzyme inhibitors, clonidine, guanfacine, nimodipin
e, and ergoloid derivatives in AD therapy.
DATA SOURCES: Studies, review articles, and editorials identified from MEDL
INE searches (from 1989 to 1997) and bibliographies of identified cuticles.
STUDY SELECTION: Studies and review articles addressing antioxidant, antihy
pertensive, and ergoloid derivative pharmacotherapy research.
DATA EXTRACTION: Pertinent information was selected and the data synthesize
d into a review format.
DATA SYNTHESIS: AD is a progressive neuropsychiatric disorder of unknown et
iology. Studies evaluating the possible association between a free radical
mechanism in PLD and the potential role of antioxidants are reviewed. Addit
ionally, the role of beta-blockers, angiotensin-converting enzyme inhibitor
s, clonidine, guanfacine, nimodipine, and ergoloid derivatives in AD manage
ment are discussed.
CONCLUSIONS: Preliminary evidence suggests that antioxidants may have a pro
tective effect against the development of AD. Additional prospective, doubl
e-blind. placebo-controlled studies are needed to determine the role of ant
ioxidants in the prevention and management of AD. Understanding the role of
antioxidants in AD may suggest alternative agents that have similar pharma
cologic activity. beta-Blockers may be an option to control agitation in PL
D patients for whom anxiolytics or antipsychotics are ineffective or are co
ntraindicated because of their adverse effect profiles. Other agents that m
ay have a role in AD therapy include angiotensin-converting enzyme inhibito
rs, nimodipine, and ergoloid derivatives. Clonidine and guanfacine have thu
s far shown little promise in improving cognitive function in AD. Further p
rospective, double-blind, placebo-controlled trials will be necessary to el
ucidate the rule of these agents in PLD management.