Recently there has been a bit of a break through in the area of Alzheimers treatment which has come to my attention through an article by Scientific American.
The original study article was published in Nature.
Here are my thoughts through the lens of an evidence based herbalist.
Although only a small scale study so far, there have been strong indications that this drug can reduce the amyloid-beta plaque buildup in the brain. This is one of the main causes for Alzheimers (though not the only one).
Larger scale studies are sure to follow within the next year or 2.
Prevention for conditions such as Alzheimers and Dementia are by far the most effective. Without question the best preventative medicines come from the nutritional and herbal standpoints. Botanical medicines offer a slurry of chemicals to the body, many of which are highly medicinal, while others may increase the effectiveness of the "key active chemicals", and others yet reducing the side effects from these chemicals.
If these botanical (or synthetic versions) are concentrated and used without these other synergistic chemicals they often provide quick and profound results, but can also be toxic or ineffective when used alone. When it comes to prevention, it is much more beneficial to use these more holistic medicines to keep the problem at bay, as there isn't generally a need for fast acting interventions.
When these conditions do present themselves however, stronger, more risky medications are often needed, and this is an area where concentrated herbal extracts, and pharmaceutical reductionist medicines excel.
It is not logical to prejudice a medicine because it is either natural or synthetic, rather we need to accept the evidence as it presents itself and choose the most effective for each individual situation.
What is Alzheimers?
Alzheimers is characterized by a buildup of amyloid-beta plaque in the synapses of the brain, which eventually lead to the destruction of the neurons.
When the enzyme acetylcholinesterase breaks down the neurotransmitter acetylcholine (associated with many actions within the brain including memory formation and retrieval, and learning), byproducts such as this amyloid-beta is formed.
This plaque begins to accumulate and eventually "plugs-up" the synapses in which the messenger neurotransmitters travel between to communicate between neurons.
This is why using substances to prevent this (such as acetylcholinesterase inhibitors like muira puama, and many nootropics) are considered the best way to avoid or prevent Alzheimers.
But what do you do if Alzheimer's still develops or is already present?
Preventing the buildup of this amyloid-beta on the synapses is still a useful strategy for slowing the progression of this condition, but is not going to be effective in treating the synapses that are already clogged up.
This is where aducanumab comes in
This drug is actually an enzyme that breaks apart these plaques. We have this enzyme naturally in our bodies, but for one reason or another it is not sufficient enough in Alzheimers patients.
Trials investigating this drug have already shown that it has the ability to dissolve these plaques, and although small scale, the patients in the trial did show indications of cognitive improvement when using the drug.
The effects were not surprisingly noted to be stronger with higher doses.
Unfortunately, as with nearly all reductionist drugs on the market, both natural and pharmaceutical, there is in fact a significant side effect...
Aducanumab increases the risk of hemmorhagic strokes, especially at the higher dose.
This fatal condition is not to be taken lightly, but also should not be the sole reason to avoid developing this new medicine further. Rather, we need to find ways of reducing this terrible side effect so that it does not occur as frequently, or find alternative treatments to accomplish the same thing.
Just as with conditions such as HIV, and cancer, multiple compounding medications are used in what is often termed a "cocktail" to treat the condition from multiple angles, including reducing the likelihood of side effects. Alzheimers is likely no different, especially since it is not the result of only one factor. It is a highly complex disease process with many layers of contributing factors.
Combining drugs and substances to work "synergistically" with the drug to reduce side effects, and improve the overall effectiveness of the treatment may go a long way in making this a successful treatment for this common and debilitating disease.
For example, perhaps we could combine the plaque dissolving Aducanumab with substances such as ginseng, with actions proven to protect and strengthen the vascular system [2].
This or similar substances that can improve the strength of the vascular system may help to prevent the occurrence of brain haemorrhage, and allow the Aducanumab treatment to be used for longer or in higher doses in order to more effectively treat Alzheimers.
This is an area that needs more study and is only a suggestion for research and possible theories of synergy.
Final Notes on Aducanumab
Overall Aducanumab has already began to show promise in treating the debilitating and all to common condition known as Alzheimers, but it is not perfect. We need to keep this research going and keep our minds open to synergistic combinations with botanical, or pharmaceutical match's in order to treat this condition more effectively, and with less side effects.
The bottom line is still, and forever will be that prevention is without a doubt the best treatment for this condition!
Reference Cited
Sevigny, J., Chiao, P., Bussière, T., Weinreb, P. H., Williams, L., Maier, M., ... & O’Gorman, J. (2016). The antibody aducanumab reduces Aβ plaques in Alzheimer’s disease. Nature, 537(7618), 50-56.