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Effect of Noradrenergic Drugs Explored in Alzheimer Disease

Meta-analyses suggest positive effects of noradrenergic drugs on global cognition, apathy

FRIDAY, July 29, 2022 (HealthDay News) — Noradrenergic drugs seem to have a positive effect for general cognition and apathy in Alzheimer disease, according to a review published online July 5 in the Journal of Neurology, Neurosurgery & Psychiatry.

Michael C.B. David, M.B.B.S., from Imperial College London, and colleagues conducted a systematic review and meta-analysis to examine the efficacy of drugs with principally noradrenergic action in improving cognitive and neuropsychiatric symptoms in Alzheimer disease.

Nineteen randomized controlled trials with 1,811 patients were included; of these trials, six, seven, and six were judged as good, fair, and poor quality, respectively. The researchers found that noradrenergic drugs had a significant, small positive effect on global cognition in a meta-analysis of 10 trials (1,300 patients), measured using the Mini-Mental State Examination or Alzheimer’s Disease Assessment Scale-Cognitive subscale. There was no significant effect on measures of attention. A large positive effect of noradrenergic drugs was detected in the meta-analysis of eight trials (425 patients) examining apathy. After removal of outliers to account for heterogeneity across studies, this positive effect was still present.

“Based on this meta-analysis, and recognition of the importance of locus coeruleus-noradrenergic system in multiple neurodegenerative diseases, there is a case for further clinical trials of noradrenergic agents in Alzheimer’s disease and other neurodegenerative conditions,” the authors write.

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