Question

Cognitive dysfunction, involving significant and progressive problems with normal mental functioning, is obviously the main symptom of dementia/Alzheimer’s disease. I understand that there are a growing number of drugs that can be used to treat dementia. Could any of these drugs also be used to treat similar aspects of ME/CFS? And have any clinical trials taken place?

Answer

There are three prescription-only drugs that may help some people with mild to moderate dementia. However, they are not a cure and, in some cases, they have little or no effect on symptoms. These drugs are known as acetylcholinesterase inhibitors. They inhibit the activity of an enzyme called acetylcholinesterase, that breaks down a chemical called acetylcholine, which helps nerve cells to communicate with each other.

These drugs can therefore help to increase the level of this vital brain chemical transmitter. One such drug, Galantamine, was assessed in a small clinical trial involving people with ME/CFS several years ago. Unfortunately, no obvious benefits were found in relation to either fatigue or cognitive dysfunction.

The cause of cognitive dysfunction in ME/CFS is far more uncertain than the situation in dementia. Current evidence indicates that this it is not related to problems with the level of acetylcholine or to the build up of the harmful amyloid plaques that occurs in dementia. Problems with blood flow to parts of the brain involved in mental activity seem a more likely explanation in ME/CFS.

More information

• The ME Association ME/CFS/PVFS Clinical and Research Guide (The ‘Purple Book') summarises the Galantamine trial in the Treatment section.
• Turan T et al. The Effects of Galantamine Hydrobromide Treatment on Dehydroepiandrosterone Sulfate and Cortisol Levels in Patients with Chronic Fatigue Syndrome. Psychiatry Investigation | June 2009