Idebenone. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in age-related cognitive disorders
by
Gillis JC, Benefield P, McTavish D.
Adis International Limited,
Auckland, New Zealand.
Drugs Aging 1994 Aug;5(2):133-52
ABSTRACT
Idebenone is a benzoquinone compound which has been investigated
in elderly patients with dementia. Its precise mechanism(s) of action remains
unknown, but in vitro and in vivo studies suggest the drug may diminish
nerve cell damage due to ischaemia, correct neurotransmitter defects and/or
cerebral metabolism and facilitate memory and learning. In the small number
of studies available for evaluation, idebenone was generally superior to
placebo and comparable with bifemelane, oxiracetam and nebracetam on the
basis of a number of objective and subjective tests and rating scales in
patients with mild to moderate cognitive decline. Clinical trial results
indicate that patients with mild dementia seem more likely to respond than
those with greater functional decline. The degree of benefit conferred by
idebenone is often difficult to determine, but in those who respond, improvement
is generally mild to moderate. Therapy with idebenone appears well tolerated
for up to 2 years, and no changes in vital signs or laboratory values have
been seen in clinical trials. In view of the lack of a proven agent to limit
or halt the progression of dementia in the elderly, idebenone may warrant
consideration in patients with mild cognitive dysfunction on the basis of
preliminary evidence of predominantly mild improvement of functional status
in some patients and good tolerability. However, further well designed studies,
including comparisons with newer and commonly used agents, such as tacrine,
are required to better define the role of idebenone in this complex area
of treatment.
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