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At 03:22 24/04/97 -0400, Margie Nestler wrote: >HI ALL- In today's Pittsburgh Post Gazette Washington- High doses of Vitamin E may slow the deterioration of some patients suffering with Alzheimer's disease,..It also found selegiline, a commonly prescribed medicine for Parkinson's disease under the brand name Eldepryl, was virtually as effetive as the vitamin.< Hi Margie, I caught the tail end of a report re the above on TV last night. Did they say that the two (vitamin E and seligilene) should not be taken together? Judith ------------------------ Hello Judith, et al -- The Reuters article states: "But the combination of the drugs showed less of an effect, with a delay of only 145 days." This is certainly an interesting finding given the previous studies' results that were done using Eldepryl & Vit. E with Parkinson's subjects. Margaret Thursday April 24 1:26 PM EDT Treatments Slow Alzheimer's Progression NEW YORK (Reuters) -- Two drug treatments may help slow the progression of Alzheimer's disease, researchers say. Taken separately, either selegiline (Eldepryl) or a high daily dose of vitamin E (alpha-tocopherol) slowed deterioration in the ability to perform basic daily tasks -- such as bathing, dressing, and handling money -- by about 25%. People with moderately severe Alzheimer's disease taking the drugs were able to delay entering nursing homes by about seven months. "We looked at the signs and symptoms of Alzheimer's disease that can worsen over time and found that in patients taking these drugs, these signs occurred later," says Dr. Mary Sano, lead study author and associate professor of clinical neuropsychology at Columbia University in New York City. However, the researchers found no improvement in cognitive function -- that is, memory, attention, language, and comprehension -- in any of the treated patients. The study, published in this week's issue of The New England Journal of Medicine, examined the effects of the two drugs in 341 patients with severely moderate Alzheimer's disease. Participants were divided into four groups, each group received a different drug regimen: either 10 milligrams of selegiline per day; 2,000 IU (international units) of vitamin E per day; a combination of both drugs; or placebo (inactive) pills. All patients were evaluated every three months for two years with particular attention paid to four important milestones of disease progression -- loss of the ability to perform basic daily activities, progression to severe dementia, institutionalization, and death. A significant delay in the onset of these Alzheimer's milestones was found after treatment with either drug. With selegiline, compared to placebo, it took 215 days longer to reach any of the four milestones. With vitamin E, the delay was about 230 days. But the combination of the drugs showed less of an effect, with a delay of only 145 days. Looking at the milestones separately, the treatment groups did somewhat better in most categories than the placebo group. However, the findings were not statistically significant -- that is, they could have happened by chance -- except for a 13% reduction in nursing home entry among people taking vitamin E. But when it came to everyday activities, people in the three treatment groups showed a 25% slower deterioration in abilities such as eating, dressing, or cooking. But the treatment had a downside. "Falls and syncope (fainting) were more frequent in the treatment groups." write the researchers. "However, these events did not lead to the discontinuation of treatment, and we conclude that each agent alone may be relatively well tolerated by patients with Alzheimer's disease." According to the researchers, the study results suggest that the effects of the drugs in delaying disease milestones may be due to their antioxidant properties leading to improvements in general health. Both selegiline and vitamin E may work to maintain health by fighting oxidative damage in heart and blood vessel tissue cells, and by improving immune system functioning. "This study reinforces the thinking that oxidative damage plays a role in Alzheimer's disease, and we are actively pursuing this line of research," says Dr. Neil Buckholtz, acting chief of the dementias of aging branch at the National Institute on Aging in Bethesda, Maryland. But the researchers note that additional studies are needed to establish the usefulness of these drugs in the long-term management of Alzheimer's disease. They caution that "little is known about the efficacy of these compounds in other patients, such as those with mild cognitive impairment, early dementia, or the very late stages of Alzheimer's disease." Commenting on the two-year study, which is the longest so far for testing drugs that might slow progression of Alzheimer's, Department of Health and Human Services Secretary Donna E. Shalala is somewhat more optimistic. She says the findings are "very good news. Each piece of the Alzheimer's disease puzzle that falls into place moves us one step closer to relieving the burden of this devastating disease." Both selegiline (a drug widely used to treat Parkinson's disease) and vitamin E are available in the U.S. Experts at the National Institutes of Health caution that selegiline has potential side-effects, and can interfere with the action of other drugs. And the dose of vitamin E used in this study was much greater than that usually taken on a daily basis. Large doses of the vitamin can cause bleeding in some people. They advise Alzheimer's disease patients and their families to consult with their doctors about drug therapy. SOURCE: The New England Journal of Medicine (1997;336:1216-1222) Margaret Tuchman (55yrs, Dx 1980)- NJ-08540 [log in to unmask]