Propranolol for Disruptive Behaviors in Nursing Home Residents With Probable or Possible Alzheimer Disease

Abstract

Short-term propranolol augmentation treatment appeared modestly effective and well tolerated for overall behavioral status in nursing home residents with probable or possible AD complicated by disruptive behaviors. Propranolol may be helpful specifically for aggression and uncooperativeness (the behaviors assessed by the NPI "agitation/aggressiveness" item). However, the usefulness of propranolol in this very old and frail population was limited by the high frequency of relative contraindications to beta-adrenergic antagonist treatment and diminution of initial behavioral improvements over time.

Noradrenergic dysfunction in Alzheimer's disease

“…In fact, some noradrenergic drugs have been tested in AD patients to alleviate some of the mood symptoms associated with AD. For example, tricyclic antidepressants, which block norepinephrine transporters, have been used to treat depressed AD patients (Sallee and Pollock, 1990; Teri et al, 1991), and both α 1 and β receptor antagonists can improve agitation in AD (Pauszek, 1991; Shankle et al, 1995; Peskind et al, 2005; Wang et al, 2009a). While these noradrenergic drugs are effective in the treatment of the behavioral and mood disorders associated with AD, further research is needed to elucidate their effect on cognition.…”

Repurposing Drugs in Oncology (ReDO)—Propranolol as an anti-cancer agent

“…A special oral formulation, (Hemangiol in Europe, Hemangeol in the USA), has also been licensed by the EMA and FDA, for the treatment of infantile hemangioma. There is also clinical trial data supporting the off-label use of PRO in a number of conditions, including haemorrhage, sepsis and hypermetabolic syndrome associated with severe burns [1], akathisia associated with Alzheimer’s disease or psychosis [2], and aggression associated with brain injury or disease [3]. …”

What have we learned from the streptozotocin-induced animal model of sporadic Alzheimer’s disease, about the therapeutic strategies in Alzheimer’s research

“…Treatment with higher (0.1 mg/kg) dose of candesartan decreased oxidative stress (MDA and GSH) and free radicals, and restored increased AChE activity (Tota et al 2009). Intranasal treatment of the APP/PS1 transgenic mouse AD model of AD with losartan, angiotensin II receptor antagonist (10 mg/kg every other day for 2 months), using at a dosage far below its systemic antihypertensive dose, exerted direct neuroprotective effects via its Aβ-reducing and anti-inflammatory effects in the central nervous system Beta blockers have been tested in AD clinical trials for the efficacy in reducing the disruptive behaviour, but not the cognitive improvement (Peskind et al 2005). …”