Overview of Clinical Trials of Hydergine in Dementia

Schneider, Lon S.; Olin, Jason T.

doi:10.1001/archneur.1994.00540200063018

Cited by 61 publications

(18 citation statements)

References 14 publications

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“…Pentoxifylline, 134 nimodipine, 135 hydergine, 136 propentofylline, 137 gingko biloba extract 138 and aspirin 139 have been investigated in this context. These trials have involved patients already diagnosed with dementia and are therefore classified as secondary prevention.…”

Section: Prevention Of Dementia Due To Strokementioning

confidence: 99%

Preventing Dementia

Black

Patterson

Feightner

2001

Can. J. Neurol. Sci.

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Suppl. 1 -S56The concept of primary prevention of dementia is relatively new but will assume increasing importance as dementia prevalence increases in our graying population 1 and as the etiological factors and molecular pathogenetic mechanisms of primary degenerative dementias become better understood. 2Current definitions of dementia require memory impairment and cognitive dysfunction in at least one other domain of sufficient degree to interfere with social functioning.3 In this review we emphasize prevention of dementia in individuals who are cognitively normal but may be at risk for dementia, or who are cognitively impaired but not yet demented. Potential preventative measures include avoidance or control of modifiable risk factors to prevent progression to clinically manifest dementia. Secondary prevention of the degenerative dementias is equivalent to treatment, which is discussed in a companion article in this series. Recent clinical trials have provided evidence for modest symptomatic stabilization with socalled cognitive enhancing agents. If effective retardive therapies or neuroregenerative strategies are developed, in the future it may be possible to delay progression or even partially reverse dementing illness.ABSTRACT: Primary prevention will become increasingly important as dementia prevalence increases and effective retardive therapies are developed. To date, only one randomized controlled trial (involving treatment of systolic hypertension) has demonstrated that the incidence of dementia can be reduced. Physicians should remain alert to possible secondary causes of dementia and correct these whenever possible. Primary and secondary prevention of stroke should reduce dementia related to cerebrovascular disease either directly or as a comorbid factor in Alzheimer's disease (AD). Epidemiological studies have revealed a number of risk factors for AD including genetic mutation, susceptibility genes, positive family history, Down's syndrome, age, sex, years of education, head trauma and neurotoxins. In casecontrol studies non-steroidal anti-inflammatory medication and estrogen replacement therapy appear to decrease the relative risk of developing AD. Further research to develop and test preventative therapies in AD and other dementias should be strongly encouraged.RÉSUMÉ: Prévention de la démence. La prévention primaire va devenir de plus en plus importante à mesure que la prévalence de la démence augmente et que des stratégies efficaces pour en retarder l'apparition sont développées. Pour l'instant, une seule étude randomisée contrôlée (traitement de l'hypertension systolique) a démontré que l'incidence de la démence peut être réduite. Les médecins devraient demeurer vigilants pour détecter la présence causes secondaires de démence et les corriger si possible. La prévention primaire et secondaire de l'accident vasculaire cérébral devrait diminuer l'incidence de la démence reliée à la maladie cérébrovasculaire, soit directement ou comme facteur de comorbidité dans la maladie d'Alzheimer (MA). Des étud...

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Section: Prevention Of Dementia Due To Strokementioning

confidence: 99%

Preventing Dementia

Black

Patterson

Feightner

2001

Can. J. Neurol. Sci.

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“…Despite a variety of scales measuring the extent and impact of AD, there is a consensus that outcome measurement remains a key challenge for clinical trials of anti-dementia drugs [1][2][3][4], For a potential compound to be demon strably effective, two conditions must be met; the compound must be effective, and the mea sures by which it is evaluated must be respon-sive. Responsiveness, or sensitivity to change, is a key component of the measurement prop erties of a test [5,6], Data on the responsive ness of measures used in anti-dementia drug trials are nevertheless scarce [7,8]. In addi tion, there remains a theoretical problem of knowing what would constitute a beneficial treatment effect in dementia.…”

Section: Introductionmentioning

confidence: 99%

Use of Goal Attainment Scaling to Measure Treatment Effects in an Anti-Dementia Drug Trial

et al. 1996

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We report data on the validity and responsiveness (i.e. sensitivity to change) of assessment instruments including Goal Attainment Scaling (GAS), at a single site in a multicentre trial of the experimental therapeutic agent linopirdine. Fifteen people (11 women) were evaluated. GAS yielded a mean 3.7 goals per patient (range 2–6). The mean gain in the GAS scores, 2.7 ± 16.4, was compared to changes in the Alzheimer''s Disease Assessment Scale-Cognitive Section, the Global Deterioration Scale, Clinical Global Impression and the Mini-Mental State Exam. GAS had the largest relative efficiency (0.47) when compared to the standard. GAS also had the largest effect size (0.61). The data suggest that an individualized approach may have merit as an outcome measure and as a means to better understanding treatment effects. Qualitative analysis revealed consistent goal setting in self-care, behaviour, cognition and leisure, suggesting that these areas should routinely be evaluated.

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“…Ticlopidine was the first of the new class of thienopyridine derivatives that inhibit platelet aggregation and are adenosine diphosphate (ADP) receptor antagonists. [8][9][10][11] Ginkgo biloba, one of the longest-living tree species, is the source of the ginkgo biloba drug, which is an extract from its leaves. 1,2 Ticlopidine is effective in preventing cardiovascular disease events, such as myocardial infarction, unstable angina, stroke, and transient cerebral ischemia.…”

mentioning

confidence: 99%

The Effects of Ergoloid Mesylates and Ginkgo Biloba on the Pharmacokinetics of Ticlopidine

Huang

Lai

2006

The Journal of Clinical Pharma

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Ticlopidine is sometimes coadministered with ergoloid mesylates or ginkgo biloba in clinical situations. Our objective was to examine the effect of ergoloid mesylates and ginkgo biloba on ticlopidine pharmacokinetics. Ticlopidine, ergoloid mesylates, and ginkgo biloba significantly inhibited the organic anion transporting polypeptide (OATP-B)-mediated uptake of [(3)H]-estrone-3-sulfate in a concentration-dependent manner. When ergoloid mesylates was coadministered with ticlopidine, the ticlopidine area under the plasma drug concentration-time profile (AUC) from 0 to 12 hours was decreased 30% and the peak plasma drug concentration (C(max)) was decreased 29%, compared with ticlopidine administration alone. There were no significant changes in the pharmacokinetic parameters of ticlopidine when it was coadministered with ginkgo biloba. In summary, ergoloid mesylates is a more potent inhibitor of OATP-B than is ginkgo biloba, and it can reduce the oral bioavailability of drugs transported by OATP-B. Ergoloid mesylates markedly decreased the AUC and C(max) of ticlopidine, probably by inhibiting the OATP-B-mediated uptake of ticlopidine during the intestinal absorption phase. The results support a new model of intestinal drug-drug interaction.

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Overview of Clinical Trials of Hydergine in Dementia

Cited by 61 publications

References 14 publications

Preventing Dementia

Preventing Dementia

Use of Goal Attainment Scaling to Measure Treatment Effects in an Anti-Dementia Drug Trial

The Effects of Ergoloid Mesylates and Ginkgo Biloba on the Pharmacokinetics of Ticlopidine

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