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As 63-year-old Fari Farvadin slips away from her loved ones into the debilitating grip of Alzheimer's, her daughter, Mary Amiri has been desperate to try anything to slow the progression of the disease.
This summer, with the help of her brother in Austria, Amiri was able to buy a three-month supply of memantine, a new class of drug for treating the symptoms of Alzheimer's. Memantine has long been available in Europe but only recently got the FDA's nod for use in this country. It won't be available in pharmacies here until at least January.
The Austrian pharmacist would not renew the medication beyond the 90-day supply without a prescription from Farvardin's doctor. So last month, Amiri was forced to take her mother off memantine just when she was beginning to show signs of improvement.
She is talking again in the mornings,'' Amiri said.She's saying, 'Good morning. How are you?' For a while, she didn't do that.''
Amiri's mother is in the advanced stages of Alzheimer and can do little for herself. In brief moments of clarity, she can still respond to her daughter, her husband Bahram and her 5-year-old granddaughter Ashley.
Like millions of Americans, Amiri is eagerly awaiting the arrival of memantine, which will be marketed by Forest Laboratories of New York under the brand name of Namenda. Memantine is the first drug approved in the U.S. for slowing the advance of moderate to severe Alzheimer's - the stage when patients typically begin to lose the ability to care for themselves.
In some tests, memantine slowed physical decline by about 50 percent over a six-month period. In a few patients, memory and thinking skills improved as well. Over a seven-month period, patients taking memantine needed 45 fewer hours of care each month than those on placebo.
Even better news is that at least one study has shown that memantine may give a boost to existing drugs that slow the early stages of Alzheimer's - adding another year or two of benefit to the average six-year effectiveness of current medications.
For families trying to keep a loved one at home, or in touch with their memories, those extra years are precious indeed.
Memantine is not a miracle cure. It's not going to reverse the disease. But even if it can keep people stable for another year or two or more, that little bit can go long way,'' said Dr. Douglas Scharre, director of the division of neurology at Ohio State Medical Center in Columbus.Maybe they can stay home longer. Or it can reduce the amount of their care and its cost. Maybe, too, it means a better quality of life.''
Memantine is the first of a new class of drugs that block excess amounts of a brain chemical called glutamate that allows calcium to collect in nerve cells and damage or destroy them. The four other drugs already in use in this country against Alzheimer's, such as Aricept, treat mild to moderate symptoms of the disease by boosting the levels of a brain chemical called acetylcholine, which helps carry messages between nerve cells.
Doctors are likely to give memantine in combination with the Aricept class of drugs, since the two types work differently on the brain and have shown no adverse effects when taken together.
``Even though it's approved for moderate to severe cases, I don't see why memantine couldn't be used for earlier onset cases. But the dust hasn't settled on that issue yet,'' said Dr. Kenneth Pugar, chairman of the Memory Disorder Center at Wallace-Kettering Neuroscience Institute at Kettering Hospital in suburban Dayton.
Side effects from memantine have been minimal, although it can cause dizziness, headache and anxiety or agitation in 2 percent to 10 percent of cases, Scharre said. And unlike Aricept, it causes little, if any, stomach upset and diarrhea, he said.
Ohio State Medical Center recently completed clinical trials of a drug cousin to memantine, called Neramexane, the next in a series of glutamate blockers being tested by Forest Laboratories. All 20 patients in that study were able to tolerate the new drug, Scharre said.
Amiri said she is willing to enroll her mother in any clinical trial that she can.
``I just hope they find a miracle,'' she said.
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c.2003 Cox News Service
