One brain disorder is not like the other. Or is it? A drug for ADHD also seems to reduce the symptoms of Alzheimer’s disease. The effect is convincing enough for further research.

The overlap between ADHD and Alzheimer’s lies in the disturbed functioning of the hormone noradrenaline, which is produced in the locus caeruleus (blue core), a brain region in the brainstem that is crucial for memory, attention span, learning ability, willingness to act and suppression. of inappropriate behavior.

This area is already affected in an early stage of Alzheimer’s disease. It contributes to the cognitive and neurological symptoms that characterize the condition. There have been indications for some time that drugs that affect the action of noradrenaline can suppress the symptoms of Alzheimer’s. Think of drugs such as methylphenidate (the active ingredient in Ritalin and Concerta), atomoxetine (also a noradrenaline reuptake inhibitor) and guanfacine (for ADHD and low blood pressure).

Pretty positive

To find out more about this effect, scientists from, among others, the Imperial College London all studies on this subject, published between 1980 and 2021, side by side. Nineteen of these studies focused on Alzheimer’s and mild cognitive complaints. A total of 1,811 patients took part in this. A number of studies were of too poor quality, so in the end the meta-study included ten studies with 1,300 patients. The effect of drugs on orientation, attention span, memory, verbal skills, language and spatial-visual capacities was examined.

This showed a small, but significant positive effect of the drugs on general cognitive skills, based on the so-called MMSE (Mini-mental State Examination), which can be used to diagnose Alzheimer’s and dementia.

Apathy

After that, further research was done on eight studies with 425 patients. Behavioral characteristics such as anger and apathy were examined. The drugs were found to have a large positive effect on apathy, even after adjusting for differences in study format and subject. “Most likely, the noradrenergic drugs could be effective in treating Alzheimer’s, especially in the area of ​​apathy, but also in terms of general cognitive skills,” say the researchers, whose study appeared in the Journal of Neurology Neurosurgery & Psychiatry† “It is important that specific clinical trials are started for the treatment of Alzheimer’s with these drugs.” Attention must also be paid to the correct selection of patients: what stage of Alzheimer’s are they in? The dosage of the drugs and their interaction with other treatments should also be carefully considered.

So it is slowly starting to look like ADHD drugs can reduce Alzheimer’s symptoms, although there is still a long way to go. Moreover, the drugs already exist and as far as we know they are not very harmful. A hopeful message for the tens of thousands of Dutch people every year who are told that they have Alzheimer’s.

What is norepinephrine?

Noredraline or norepinephrine is a neurotransmitter that affects mood. People who produce too little noradrenaline generally feel down or depressed. Too much of the hormone leads to a euphoric, tense or anxious feeling.

Norepinephrine is sometimes given to patients with extremely low blood pressure. Depressed people can take drugs that stimulate the production of the neurotransmitter. People with ADHD are given drugs that inhibit the reuptake of noradrenaline, such as Ritalin.

Caffeine also affects the action of noradrenaline. It strengthens the receptors for noradrenaline and thus increases the effect. Drugs such as cocaine and MDMA also have a stimulating effect on noradrenaline.

The body produces noradrenaline just like adrenaline in acute stress situations. Blood pressure rises and blood flow to the digestive system decreases, making blood available to the brain and muscles.