Hydergine in Senile Mental Impairment

Loew, D.; Weil, Claude

doi:10.1159/000212511

Cited by 29 publications

(6 citation statements)

References 10 publications

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“… c Failure to come back ( 3 ), exitus for heart failure ( 2 ), patient's refusal for gastric pain and hot flushes ( 1 ). …”

Section: Resultsmentioning

confidence: 99%

“…D espite ample evidence of a real, though limited, effectiveness of ergot derivatives in senile mental deterioration, 1–5 there seems still to be a rather diffuse impression among clinicians and clinical pharmacologists that these compounds are of little use and work no more than a placebo 6 . Wittily, Goodwin and Goodwin 7 referred to these compounds as an example of the so‐called “tomato effect.” Indirectly contributing to this concept are speculations that the daily doses in most trials might have been too low or the duration of treatment too short 8 .…”

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confidence: 99%

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Nicergoline in Mild to Moderate Dementia: A Multicenter, Double‐Blind, Placebo‐Controlled Study

Baroni

Cisbani

Bovi

et al. 1989

J American Geriatrics Society

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In view of some controversies still existing about the real efficacy of ergot derivatives in the management of dementia, a double-blind, randomized, parallel group trial extending up to 6 months was carried out to compare the effects of nicergoline, 60 mg daily, and placebo in 315 patients suffering from mild to moderate dementia. Clinical evaluation was performed by the SCAG scale. The trial, which included a 1-month placebo run-in period, showed that both placebo and nicergoline were associated with some degree of improvement. The effect of nicergoline, however, was significantly greater and more sustained, steadily increasing with time. In particular, the difference between nicergoline and placebo in mean total SCAG score was 5.5 at 3 months (95% confidence interval: 3.6-7.4) and increased to 9.8 at 6 months (95% confidence interval: 7.8-11.8). A comparison of nicergoline versus placebo in the frequencies of changes in each item of the SCAG showed also a significant difference at 6 months, the percent of patients displaying an improvement by at least 2 points ranging from 13.5 (bothersome) to 30.2 (disorientation) in nicergoline group, against 4.1 (self-care) to 14.3 (fatigue) in placebo group. The safety of nicergoline, as judged by hemodynamic changes and drug-related adverse reactions, was quite satisfactory.

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“… c Failure to come back ( 3 ), exitus for heart failure ( 2 ), patient's refusal for gastric pain and hot flushes ( 1 ). …”

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Nicergoline in Mild to Moderate Dementia: A Multicenter, Double‐Blind, Placebo‐Controlled Study

Baroni

Cisbani

Bovi

et al. 1989

J American Geriatrics Society

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“…The basic pharmacodynamic profile of co-dergocrine mesylate has been demonstrated in numerous experimental studies (Loew et al 1980;Loew & Weil 1982;Markstein 1985;Spagnoli & Tognoni 1983;Weil 1988). However, the mechanism of action of co-dergocrine mesylate has yet to be established conclusively.…”

Section: Pharmacodynamic Propertiesmentioning

confidence: 97%

Co-Dergocrine Mesylate

Wadworth¹,

Chrisp²

1992

Drugs & Aging

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Co-dergocrine mesylate is a combination of the mesylated forms of dihydroergocornine, dihydroergocristine, dihydro-alpha-ergocryptine and dihydro-beta-ergocryptine. In animal models and healthy elderly volunteers the compound improves indices of cognitive function such as memory and learning. The mechanism(s) behind such action remains under investigation. Nonetheless, it has been proposed that co-dergocrine mesylate has a dual effect on central monoaminergic neurotransmitter systems, compensating for both hyperactivity and deficits of the adrenergic, serotoninergic and dopaminergic systems. The compound also appears to have a normalising effect on the power of electroencephalogram frequencies, and may improve cerebral metabolism. Results from controlled studies of elderly patients with age-related cognitive decline have established that co-dergocrine mesylate is well tolerated and, in some studies, had statistically significant positive effects on symptoms of cognitive dysfunction. However, there is considerable controversy over the clinical relevance of these results as there was wide variability in the number and type of cognitive and neuropsychological assessments used in individual studies and there may have been considerable overlap in diagnosis of patients with varying degrees of dementia. In addition, the drug has not been compared with most other, more recently developed, centrally active agents. Thus, the specific place of co-dergocrine mesylate in the treatment of age-related cognitive decline remains undetermined, despite many years of clinical use.

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“…The ergoloid mesylates have been available for the past three decades. Though originally manufactured as a vasodilator, Hydergine (a combination of the ergoloid mesylates) was found to affect the serotonin and dopamine systems as an agonist (Loew and Weil, 1982). There continue to be reports of its efficacy in treating dementia (McDonald and Krishnan, 1990), but studies (Thompson and others, 1990) have found Hydergine ineffective in treating Alzheimer's disease.…”

Section: Treatmentmentioning

confidence: 99%