RespireRx Pharmaceuticals Inc (RSPI)

[neuroinv]

The association with mortality via pneumonia illustrates the ugly and pyrrhic choices that result from having inadequate medication options. Cholinesterase inhibitors and memantine do rather little for cognition; antipsychotic drugs are, to some degree, massive firepower being diverted to the secondary symptoms of dementia (paranoia, agitation). It's easy to say, as some do, that they are overused, that nursing home staff use them for patient 'management', as if it's just convenience-based. But it's not that simple--it is not easy to calm a demented patient who is 'filling in the gaps' of their impaired cognition with paranoid ideation, and has become panicky and agitated. That's not exactly quality of life.

How do I know? Well, besides consulting to a dementia unit for a decade: My mother died ten days ago, after suffering from Alzheimer's for eight years. For several years, she needed low-dose antipsychotic medication, because without it, she was paranoid and frightened. With it, she was pretty much OK with her situation and caregivers. As her dementia worsened, she eventually did not need antipsychotic medication, because so far as I can tell, one needs a certain amount of intact cognition to generate paranoia. And over the past three years, when she did not recognize anyone in her family, she no longer possessed either that cognitive capacity, or the paranoid fearfulness that it could engender.

Frankly, the antipsychotic drugs are a side issue, reflective of our present-day therapeutic impotence; the fact that current Alzheimer's therapies provide limited benefit, for a limited amount of time, for a limited subset of the dementia population.

NeuroInvestment