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Emerging Uses of FDA-Approved Drugs

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MS Cognitive Study Using Alzheimer Drug (Aricept, Pfizer) Launced

Researchers nationwide are launching the first large-scale clinical study of cognitive symptoms in patients with multiple sclerosis. The work builds upon a smaller study by doctors at the University of Rochester Medical Center, in which several patients with MS improved while on Aricept.

The study  includes 240 patients at 21 hospitals and medical centers around the country. Aricept is  FDA-approved for the treatment of mild to moderate dementia from Alzheimer’s disease.

"In the last few years several medicines have become available to treat MS," said Steven Schwid, M.D., assistant professor of neurology, University of Rochester, who is lead investigator for the new study. "These medications help slow the progression of the disease, holding symptoms more stable, but they do not improve symptoms that are already present. Right now there is nothing to treat the difficulties with memory that many patients experience."

Last year Pierre Tariot, M.D., professor of psychiatry, medicine, and neurology at the University of Rochester, reported the results of a preliminary study of 17 patients with advanced MS and severe cognitive impairment. During the three months they were on Aricept, concentration, memory, and attention span improved on average. "Half the patients showed clearly observable improvement – you could tell simply by chatting with them that they were thinking more clearly. In many patients we also saw changes in temperament; they were often less irritable, depressed, or agitated," says Tariot, who helped design the current multicenter study. While the results appeared dramatic, the previous study had limitations, including a small sample size and lack of a control group.

Aricept works by boosting the amount of acetylcholine, a chemical crucial to memory, in the brain. The same chemical also plays a role in  bipolar disorder,  schizophrenia, Parkinson’s disease, and HIV-related dementia.

"Since the medicine is useful for one disease where there are cognitive problems, Alzheimer’s, we think it may be useful for others," says Tariot. "These drugs don’t ‘know’ they’re supposed to work only in Alzheimer’s disease. It makes great sense to ask whether folks who have cognitive problems caused by other diseases can be helped with these medicines."