Levetiracetam, a once-daily anti-epileptic drug, may help treat Alzheimer’s. In a new study, a slow-release form called AGB101 slowed mental decline by as much as 40%. That held in people with mild cognitive impairment, but only in those who do not carry the ApoE4 gene variant.
Summary: A new study shows that an anti-epilepsy drug can be a significant help. It can keep mild mental decline from turning into full-blown Alzheimer’s disease. This drug may slow mental decline by as much as 40%. It seems to work only in people who do not carry the ApoE-4 gene variant.
Reusing old drugs for new jobs has real perks. Their safety is already proven in patients. Now a safe, cheap, easy-to-get anti-epileptic drug seems to help treat Alzheimer’s significantly.
The drug is called AGB101. It is a slow-release form of levetiracetam. Doctors have used this drug for a long time. It is cheap, it is known to boost brain cell energy use, and it has other benefits. Now studies show that given early enough, it may help prevent or even manage Alzheimer’s. These were the findings of the HOPE4MCI study.
Alzheimer’s builds slowly over years. So early treatment is the best time to slow it down or treat it. One early sign is mild cognitive impairment, a small but real drop in memory and thinking.
Of course, not everyone with mild cognitive impairment goes on to get Alzheimer’s. But studies show about one-third of people with mild cognitive impairment are later diagnosed with Alzheimer’s.
This new study shows the drug works only in people who do not carry the ApoE-4 gene variant. This is likely because that variant significantly raises the risk of Alzheimer’s. That does not make the study less important. More than half of all people diagnosed with Alzheimer’s do not carry this variant. So reusing this anti-epileptic drug may help a great many people.
Even in mild mental decline, the brain already shows amyloid and tau damage. Amyloid and tau are proteins that build up in the brain. Some brain parts, like the hippocampus (the memory center), also run in overdrive. At this stage, memory loss is still mild. But brain cells are dying fast, and the person is quite likely to be diagnosed with Alzheimer’s.
This drug has a known safety record and is taken once a day. It may slow the death of brain cells (brain atrophy). So it may stop mild mental decline from turning into Alzheimer’s, or slow that process. But researchers saw this benefit only in people who do not carry the ApoE-4 gene variant.
Investigators saw that the drug calmed overactive brain parts like the hippocampus. That overactivity causes mild memory problems in early dementia. So this drug could help prevent mental decline in many cases. Many of the patients got close to normal.
These results are significant. The study found an almost 40% drop in cognitive impairment, which is huge. People took the test drug for 18 months, and the results were compared to placebo. So it shows a significant, meaningful benefit.
Investigators are excited about their findings. Slowing mild cognitive impairment early would let people live on their own for longer. It would also significantly delay the start of dementia.
Better still, researchers saw that the drug also cut atrophy, or cell death, in other brain parts. So this is not just slower mental decline. It is slower loss of brain cells.
Right now, there is no cure for Alzheimer’s. But researchers want ways to prevent it or slow it down. Then people could be treated the way they are for diabetes and high blood pressure. It would be great if science finds drugs that significantly slow the disease.
When reused drugs like levetiracetam work, it is good news. Such drugs can reach patients quickly. And unlike some new biologic drugs, they are fairly cheap.
Frequently asked questions
Can anti-seizure medication help with dementia?
One anti-seizure drug shows promise at the earliest stage. The HOPE4MCI study gave AGB101 for 18 months to people with mild cognitive impairment. AGB101 is a once-daily slow-release form of levetiracetam. Compared with placebo, it cut cognitive impairment by almost 40%. It also calmed overactivity in the hippocampus and slowed the loss of brain cells.
Does levetiracetam have any effect on Alzheimer’s disease?
It helped one group. In the HOPE4MCI study, the benefit showed up only in people who do not carry the ApoE-4 gene variant. That variant sharply raises the risk of Alzheimer’s. Still, this matters, because more than half of people diagnosed with Alzheimer’s do not carry it. Levetiracetam is cheap and has a known safety record, so it could reach patients quickly.
Does mild cognitive impairment always lead to Alzheimer’s?
No. Not everyone with mild cognitive impairment goes on to get Alzheimer’s. But about one-third are diagnosed with it in time. Even at this mild stage, the brain can already show amyloid and tau changes and an overactive hippocampus. That makes it the best window to slow the disease. There is still no cure for Alzheimer’s.
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Source:
Mohs, R., Bakker, A., Rosenzweig-Lipson, S., Rosenblum, M., Barton, R. L., Albert, M. S., Cohen, S., Zeger, S., & Gallagher, M. (2024). The HOPE4MCI study: A randomized double-blind assessment of AGB101 for the treatment of MCI due to AD. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 10(1), e12446. https://doi.org/10.1002/trc2.12446