Alzheimer’s disease is a progressive neurodegenerative disorder characterized by the formation of protein plaques or clumps in the brain. Although memory loss and cognitive function decline are well-known symptoms of Alzheimer’s disease, patients also often experience neuropsychiatric symptoms such as agitation.

Managing symptoms of agitation

Agitation is reported in about 50% of patients with Alzheimer’s disease. Aggressive behavior, irritability, disinhibition, and emotional distress are some of the features of agitation. The cause of agitation in Alzheimer’s disease patients is unclear, but the imbalance in neurotransmitter levels (cell signaling molecules in the nervous system) and their impact on brain cell communication may play a role.

The patient’s healthcare team, along with a trained therapist or psychiatrist, can help them and their caregivers cope with agitation. Coping strategies include:

  • Developing a routine for daily activities such as bathing, dressing, and eating.
  • Reducing clutter and noise.
  • Speaking calmly.
  • Scheduling daily quiet times.
  • Incorporating daily relaxation techniques such as breathing exercises, soothing music, or walks.

Treating agitation

In severe cases, patients may require medications to manage their agitation. Currently, no anti-agitation treatments are approved specifically for Alzheimer’s disease. However, the doctor may prescribe antipsychotics or antidepressants.

A few experimental treatments are being evaluated to manage agitation in Alzheimer’s disease patients, including:

AXS-05

AXS-05 is an investigational therapy being developed by Axsome Therapeutics. AXS-05 is a combination of two medications, bupropion and dextromethorphan, both of which function to improve the activity of neurotransmitters in the brain. A Phase 2/3 trial (NCT03226522) called ADVANCE-1 is underway to evaluate the safety and efficacy of AXS-05 in Alzheimer’s patients. This multicenter study plans to recruit 435 Alzheimer’s patients from 65 to 90 years old at 62 study locations across the U.S.

AVP-786

Avanir PharmaceuticalsAVP-786 is an experimental therapy to treat agitation in Alzheimer’s disease patients. It is a combination of dextromethorphan, quinidine, and deuterium. Quinidine and deuterium prolong dextromethorphan’s activity by preventing its breakdown in the body. Several clinical studies are evaluating the safety and efficacy of AVP-786 in Alzheimer’s patients.

Brexpiprazole

Brexpiprazole, co-developed by Otsuka Pharmaceutical and Lundbeck, is a potential anti-agitation therapeutic for patients with Alzheimer’s disease and associated dementia. Brexpiprazole’s mechanism of action is unclear, but it is thought to function by modulating the levels of the two neurotransmitters, serotonin and dopamine. Approved by the U.S. Food and Drug Administration to treat schizophrenia, brexpiprazole is being evaluated in Alzheimer’s patients in multiple clinical trials.

Prazosin

Prazosin functions by blocking the activation of signaling molecules that increase agitation. This alpha-blocker is approved for the treatment of high blood pressure. Two clinical trials (NCT00161473 and NCT01126099) showed that prazosin significantly lowered agitation and aggression in patients with Alzheimer’s disease. An ongoing Phase 2 study (NCT03710642) is now evaluating the safety and efficacy of prazosin compared with a placebo in Alzheimer’s patients.

 

Last updated: Oct. 14, 2019

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Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Vijaya Iyer is a freelance science writer for BioNews Services. She has contributed content to their several disease-specific websites, including cystic fibrosis, multiple sclerosis, muscular dystrophy, among others. She holds a PhD in Microbiology from Kansas State University, where her research focused on molecular biology, bacterial interactions, metabolism, and animal models to study bacterial infections. Following the completion of her PhD, Dr. Iyer went on to complete three postdoctoral fellowships at Kansas State University, University of Miami and Temple University. She joined BioNews Services to utilize her scientific background and writing skills to help patients and caregivers remain abreast with important scientific breakthroughs.
Total Posts: 3
Özge has a MSc. in Molecular Genetics from the University of Leicester and a PhD in Developmental Biology from Queen Mary University of London. She worked as a Post-doctoral Research Associate at the University of Leicester for six years in the field of Behavioural Neurology before moving into science communication. She worked as the Research Communication Officer at a London based charity for almost two years.
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Vijaya Iyer is a freelance science writer for BioNews Services. She has contributed content to their several disease-specific websites, including cystic fibrosis, multiple sclerosis, muscular dystrophy, among others. She holds a PhD in Microbiology from Kansas State University, where her research focused on molecular biology, bacterial interactions, metabolism, and animal models to study bacterial infections. Following the completion of her PhD, Dr. Iyer went on to complete three postdoctoral fellowships at Kansas State University, University of Miami and Temple University. She joined BioNews Services to utilize her scientific background and writing skills to help patients and caregivers remain abreast with important scientific breakthroughs.
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