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?
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.
- 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
Medical Matters is for information purposes only. The answers provided by Dr Shepherd and the ME Association’s other expert advisers should not be construed as medical advice. We recommend that any information you deem relevant is discussed with your GP as soon as possible. It is important to obtain advice from a GP who is in charge of your clinical care, who knows you well, and who can consider other likely causes for symptoms. Seek personalised medical advice whenever a new symptom arises, or an existing symptom worsens. Don't assume that new or worsened symptoms are a result of having ME/CFS.