Therapeutic Target for Cognition Enhancers: Diagnosis and Clinical Phenomenology

Abstract

Uncertainty concerning therapeutic targets has probably retarded the development of cognition-enhancing drugs. While enhancement of normal cognitive function may be a legitimate goal it is unlikely that drugs developed without a clear clinical indication will ever be approved by regulatory authorities. Normal aging as a target would also appear to be excluded. The main debate is whether drugs should be developed for specific disease states (e.g., Alzheimer's), particular syndromes (e.g., AAMI) or for treating symptoms (e.g., memory deficits). Although targeting disease states appears the least problematic, it would be difficult to include many potentially treatable patients in such studies. In this respect, the status of AAMI is still the subject of much debate. In any case, it is important that trial populations be as homogeneous as possible, with clear diagnostic criteria (e.g., defined memory impairment, Hachinski score, CT scans) and that patients be moderately to severely affected.

Age-Associated Memory Impairment: A Suitable Case for Treatment?

“…With regard to therapy, it is noteworthy that there is a strong interest in pharmacological treatment (Spagnoli, 1991;McEntee and Crook, 1990;Crook and Larrabee, 1988;Allain 1990;Grioli et al 1990) even though the original NIMH Work Group article suggests that many aspects of the disorder, such as epidemiology, clinical characterisation and aetiology are ill-defined. Perhaps these articles reflect the realisation that AAMI is a disorder that will apply to huge numbers of individuals, a large proportion of whom will clamour for its alleviation (Spagnoli, 1991).…”

Smart drugs: Implications of student use

“…Other studies on the therapeutic application of a number of nootropics are still debating appropriate goals for drug use and which diagnostic patient groups would be most appropriate for therapeutic use of such drugs (Allain, Boyer, Kossman & Lepine, 1990). The ongoing evaluations of nootropic drug activity and effectiveness appear promising for treating diseases characterized by mental disorientation, dysfunction and decline (Alperovitch, 1989).…”