Antibiotics May Slow Alzheimer's-Related Cognitive Decline


By Megan Rauscher
NEW YORK (Reuters Health) Oct 09 - Treatment with two antibiotics,
doxycycline and rifampin, may curb cognitive decline in patients with
symptoms of Alzheimer's disease, suggest results of a study presented
Thursday at the 41st Annual Meeting of the Infectious Disease Society
of America (IDSA) in San Diego.
The findings fuel the belief that infection is involved in the
development of Alzheimer's disease. "These two antibiotics have high
activity against Chlamydia pneumonia, which is theorized to play a
role in Alzheimer's disease," Dr. Mark B. Loeb from McMaster
University in Hamilton, Ontario, who led the study, told Reuters
Health.
Previous research has shown that C. pneumoniae-infected cells are
often and selectively present in areas of neuropathology in the AD
brain (See Reuters Health report August 13, 1998). This finding,
coupled with in vitro findings suggesting that doxycycline and
rifampin interfere with the build-up of amyloid beta, led to the
current trial, Dr. Loeb said.
Conducted at five centers throughout Canada, the randomized
triple-blinded study included 101 patients with symptoms consistent
with mild-to-moderate Alzheimer's disease. Fifty-one were randomly
assigned to 200 milligrams doxycycline plus 300 milligrams rifampin,
and 50 to matching placebo daily for 3 months.
The primary outcome was a change in Standardized Alzheimer's Disease
Assessment Scale cognitive subscale at 6 months. Forty-three patients
in the antibiotic arm and 39 in the placebo arm completed the study.
The rate of cognitive decline was lower among those taking antibiotics
than among those taking placebo. "The difference in scores between the
two groups was significant at 6 months, with a p value of 0.034," Dr.
Loeb told Reuters Health.
He also noted that the "magnitude of the effect is actually in the
ballpark range of the magnitude of the effect seen with cholinesterase
inhibitors," the only medications approved by the U.S. Food and Drug
Administration and Canadian Health Protection Branch to treat
Alzheimer's disease.
Patients in this study were on stable doses of cholinesterase
inhibitors but were not responding well to them.
At 12 months, the apparent protective effects of antibiotic therapy on
cognitive decline "was actually larger, but the difference between the
two groups was not statistically significant," Dr. Loeb said.
Patients treated with antibiotics also showed a "significantly reduced
decline in Standardized Mini-Mental Status Exam Scores at 12 months
and significantly less deterioration in functional status, depression,
and dysfunctional behavior at 3 months," according to the meeting
abstract.
There were no between-group differences in C. pneumoniae detection by
polymerase chain reaction or antibodies (IgG or IgA).
These findings, Dr. Loeb said, clearly warrant additional studies. "We
need more data. This is very interesting information but other groups
should be conducting similar or larger controlled trials to see if
these findings can be replicated," the researcher said.

jellybeans, I saw something about this on TV yesterday. Interesting!

I did a quick search on Google and found that the drugs doxycycline and rifampin are also effective against Helicobacter pylori. I didn't check to see if the drugs used for Hp are effective against Chlamydia pneumonia, but it wouldn't surprise me if they are.

The question I have is, just like in the case of Rember, could the drug really have been killing off an H.pylori infection?

It probably doesn't matter which bug is the culprit. The really important thing is, I think, that whether it is C. pneumonia or H. pylori or both, it appears that these cases of AD would be treatable. I don't mean that damage already done could be completely undone, but that some symptoms could be reversed and progression arrested. That would be good.

What percentage of AD cases are due to infection? I'll wager the number turns out to be close to 75%

Are doctors likely to start prescribing these antibiotics for AD or are they likely to wait for more results?

jellybeans, studies that tried to link Chlamydia pneumoniae nucleic acids in brains to AD have yielded conflicting results.

This study that was presented at IDSA was originally reported in 2004:

http://www.ncbi.nlm.nih.gov/pubmed/14962152

They've just added another data point, at 12 months following treatment.

I doubt very much that Dr Loeb suggested that the findings "fuel the belief that infection is involved in the development of AD".

In fact, these researchers concluded that the mechanism involved in the apparent benefits that were seen is probably not due to the drugs' effect on C. pneumoniae. There were no differences in the levels of C. pneumoniae between the placebo and treatment groups, whether tested by PCR or two types of antibodies.

There are other possible mechanisms whereby rifampicin and doxycycline might affect AD. Rifampicin has been shown in vitro to interfere with the accumulation of Abeta and subsequent development of fibrils. In tissue culture studies, it inhibited Abeta(1-40) aggregation and neurotoxicity in a concentration-dependent manner. Doxycycline not only inhibited fibril formation but also disassembled preformed fibrils in vitro. Both drugs are also thought to have antioxidant activity.

http://www.ncbi.nlm.nih.gov/pubmed/16644188

So don't be misled just because these drugs also have antibiotic activity, and the reporter didn't get the facts straight.

And no, they're not going to start prescribing these drugs for AD on the basis of such a very small clinical trial -- especially in light of the serious threat of the emerging antibiotic-resistant pathogens. Dr Loeb himself says additional studies are needed.

Thanks, JAB.
Does it really matter (in the big scheme of things) why these antibiotics helped? It just matters that they did help. I've heard a few psychiatrists say that they don't know how a particular drug helps, but it helps and they prescribe them. (this isn't true of every psychotropic medication, but for some)
I understand that the wheels of research move slowly, but in my opinion, I wish they'd speed things up.
The side effects of both drugs are well known. Heck, people take doxycycline for acne for long periods of time with little or no consideration for antibiotic resistance.

jellybeans, there have been many, many drugs in Phase II trials that looked every bit as promising as this one -- if not moreso -- and then failed miserably in larger trials.

We really don't know enough about AD itself, and how to assess the progression of the disease, and how to interpret the data, to be able to determine whether a drug is beneficial. There's entirely too much variability in the raw data from small trials for them to be at all reliable. Researchers are beginning to think we need to entirely overhaul the protocols for clinical trials and data analysis methods.

And yes, it really does matter why these drugs helped (if indeed they did). If we can determine the mechanism(s) involved, then we may be able to develop much better drugs. It's simply amazing, the molecular modeling studies that can be done "in silico" (via computer) these days.

I agree that long term, it does matter why and how they work, but not for the short term.
Most of our LOs probably won't be around to benefit from many of the early research trials being conducted now. It's great that it'll help people in the future, but not so great that it won't help people currently suffering from AD.

Personally, I'd love to try my LO on Doxycycline.

I have a question (for JAB or anyone who might know). I'm not trying to be argumentative, just get information
Why is it that some doctors use Enbrel for AD and the data for that seems a little lacking (no offense at all to anyone who uses Enbrel), but doctors wouldn't prescribe these antibiotics for AD?

jellybeans, I won't comment re the Enbrel, because I think you know the answer to that one.

Re the antibiotics: some doctors do indeed prescribe certain antibiotics or antivirals for select dementia patients, e.g., those who are known to have an infection caused by a pathogen which is known to sometimes infect the brain and cause encephalopathy. Sometimes the treatments work, sometimes they don't. But an ethical doctor needs a great deal more than a very small, very preliminary clinical trial to try a given treatment if that treatment has significant potential health risks.

I know you're comfortable with antibiotics, but you shouldn't be. They should only be prescribed for known infections, and only under the established guidelines. People die every day from misusing antibiotics, and they're risking our lives as well.

Antibiotic-resistant pathogens are a rapidly growing, very, very serious global threat that the medical community is extremely concerned about.

I have a dear friend who just lost her daughter because of it. One day, she was young, healthy and happy, on vacation in Hawaii. The next day, she was dead. They have no idea how she became infected.

Mom had a blood infection and after she pulled her picc lines out twice, they gave her a very expensive antibiotic called zyvox, I hope I spelled that right.

Mom was so much more alert for the 6 pills I had for her, I never got the other 22 and would have loved to. The cost is 2,012.00 for 28 of them and covered by mom's insurance if they would have gotten prior approval.

I also noticed with the IV medicine that mom's pain in her legs was just about gone, no swelling either. I don't know why this is, I only report what I see.

Off the medicine, the swelling and pain have returned in her legs. Also, if you notice the stools with a horrible odor, the IV antibiotics take that away as well. Makes one think if a lot of things in older people are some kind of resistant bacteria as these drugs are not given just for anything, there for MRSA and staph, but I think the best one was the zyvox.

I'm sorry about your friend's daughter.

I was poking around the internet last night and they looked at people taking doxycycline for long periods of time for acne and found that there was doxycycline resistant bacteria on their skin, but it caused no harmful effects to the patients taking the drug.

I know that a good doctor will ask a patient if they've been on any antibiotics recently before prescribing a new one so that they will prescribe a different antibiotic for a new infection.

This study had about 50 less participants than the Axona study that is mentioned on their website. (I'm not trying to say Axona isn't great, just using it as a comparison.) I realize that the reason it was ok for Axona to be sold is because it's a neutriceutical (sp?) and not a drug, but the numbers aren't that different and yet doctors are prescribing Axona. (Not my Grandma's doctor, but many doctors).

As you mentioned, this study was done several years ago and there's not too much going on with this line of research right now(I think there's one study in Canada that's doing something with MRIs or something). There's no huge rush to see if doxycycline and/or rifampin would be effective in a larger clinical trial.

In my opinion, for terminal illnesses like AD and some cancers, the prescribing guidelines should be more relaxed, because there aren't a lot of effective alternatives. I think that drugs that pass the second phase of testing that show promise should be offered to people with terminal illnesses in conjunction with accepted treatment. For AD, Namenda and Aricept help, but only to a limited extent and only for certain people.

I'm going to call around and at least see if some of the "alternative medicine" doctors and the doctors using Enbreel would be willing to precribe these antibiotics for her AD. I think the holistic doctors more into the herbal stuff, but it can't hurt and might help. At least they are the type of doctors who think outside the box.

I appreciate your comments and respect your opinion, as always.

quote:

Why is it that some doctors use Enbrel for AD and the data for that seems a little lacking, but doctors wouldn't prescribe these antibiotics for AD?

The caregivers of those people getting Dr. Tobinick's Enbrel treatment searched very hard to find physicians that would do it, or take the great effort and expense to see Dr. Tobinick himself.

All new ideas lack data until they are investigated. When Alexander Flemming discovered penicillin, it was just an idea he had from a chance observation. There was no proof that it would work as an antibiotic in humans. He just had to try it. Advancements work that way. Somebody comes up with an idea, and somebody has to try it.

Most of the topics we discuss here are still in the idea phase. Your choice is to wait until the research establishment and some government agency puts their stamp of approval on them, or to forge ahead on your own. The former may take so long that your loved one will be beyond all hope by the time "they" get around to it. The latter is a lot of bother and likely to lead you down blind alleys since no one else may have been down that path before to show you the way.

I think a good strategy would be to search for a physician willing to test the victim for the presence of a chronic bacterial infection, and treat it if found. I'll go out on a limb and claim that there are certain bacteria the human body can do without. So, if even after ridding the body of a chronic infection the AD symptoms do not improve, the loss of this bacterial colony will not be a great health risk.

Antibiotics shouldn't be feared, but respected, as one must respect the power of fire.

I've tried to find a physician that would prescribe methylene blue to my mother. I know they exist, but I couldn't find one. At the time, I was interested in the tau-buster properties of the methylene blue. This was very frustrating since MB is a very old drug with no dangerous side effects in the doses being investigated. But I had alternatives to MB for this purpose so I didn't pursue it as vigorously as I could have. Now I find that methylene blue could be used as an antibiotic. But again, I have an possible alternative, sulfuraphane, which I will try first since I don't need a physician to get it. It won't eradicate the bacteria (in this case, H.pylori) if it is present, but I am convinced that eating sulfuraphane containing broccoli sprouts isn't going to be harmful.

Swarfmaker,
I bet broccoli sprouts are probably something all of us should be eating.
Thanks for the advice about how to approach the doctor, I appreciate it.
I found one alternative medicine MD in my state, the rest are NDs and I don't think they can prescribe anything.
I found one doctor last night during my search who thought that prescribing these antibiotics for AD was appropriate and he was in MD, not the farthest drive ever. I have to go back and find that site again! I should have bookmarked it.
IMO, the known side effects of doxycycline and rifampin are a better bet for my LO than the known side effects of many of the antipsychotics. And antipsychotics are hit or miss.
It can't hurt to try to find a doctor who will try this.

The doctor in MD who endorsed treating AD with antibiotics is, unfortunately retired. He advocates treating many illnesses with antibiotics and has had great success. If anyone knows of a doctor (anywhere in the continental US) who is "pro-antibiotics" for AD, osteoarthritis, etc, I'd appreciate it if you would post the doctor's name or, if you aren't comfortable doing that, let me know and I'll give you my email address.

rxlist.com, the best site I've found for side effects, drug interactions, etc, says:

Rifampin is prescribed only for treating tuberculosis or the meningococcal carrier state. When used in the treatment of tuberculosis, it is part of a three-drug regimen that also includes isonaizid and pyrazinamide.

"...Bacteriologic cultures should be obtained before the start of therapy to confirm the susceptibility of the organism to rifampin and they should be repeated throughout therapy to monitor the response to treatment. Since resistance can emerge rapidly, susceptibility tests should be performed in the event of persistent positive cultures during the course of treatment. If test results show resistance to rifampin and the patient is not responding to therapy, the drug regimen should be modified.

"...Rifampin should not be used indiscriminately, and therefore, diagnostic laboratory procedures, including serotyping and susceptibility testing, should be performed for establishment of the carrier state and the correct treatment.

"...To reduce the development of drug-resistant bacteria and maintain the effectiveness of rifampin and other antibacterial drugs, rifampin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria."


Then I went to look at Doxycycline, and was absolutely floored by the number of potential biological warfare agents that are on the list of infections for which it is prescribed, including:

Rocky mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.
Plague due to Yersinia pestis
Tularemia due to Francisella tularensis
Cholera caused by Vibrio cholerae
Brucellosis due to Brucella species
Shigella species
Anthrax due to Bacillus anthracis, including inhalational anthrax (post-exposure)

These organisms are considered to be potential BW agents because they are highly contagious, quickly lethal, difficult to treat, and readily acquired for mass production -- e.g., they kill many people in third world countries every year. Because of the ever-increasing amount of world-wide travel, they are spreading quickly to countries that usually have low incidence rates.

"To reduce the development of drug-resistant bacteria and maintain effectiveness of Monodox® and other antibacterial drugs, Monodox should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria."

Honest to pete, jellybeans. These are two of the very last antibiotics that should be experimented with just for the heck of it. And any doctor who would prescribe them for your ADLO is phenomenally stupid, phenomenally ignorant, unbelievably unethical ... or, more likely, all three.

I don't think you understand. My friend's daughter didn't die because she used antibiotics incorrectly. She died because so many other people have been using antibiotics incorrectly, that new strains of bacteria that cannot be treated by any available antibiotic have evolved, and are spreading rapidly throughout the world.

Swarf, I don't fear antibiotics -- I fear people who are ignorant, who don't understand the issues at hand, and/or who won't listen to the warnings from the experts. They are endangering all of us.

JAB,
I had looked those up as well. I really do respect your opinion, but I also, respectfully, disagree.

Doxycycline may be the treatement for some scary diseases, but is also used for acne , chlamydia, syphilis, rosacea, prostatitis, pelvic inflammatory disease and sinusitis. It's pretty commonly prescribed for these common conditions. It's bacteriostatic and not bacteriocidal, and, from my understanding, not prescribed for things like pneumonia or meningitis, ie not a concern with dying from most superbugs. As I mentioned in an earlier post, people who had taken doxycycline for years had doxycycline resistant bacteria on their skin and it didn't cause any ill effects. I'm not going to worry about what's going to happen in the event of a bioterrorist attack.

Antibiotics have also been found to help osteoarthritis and heart disease in small studies as well. I found one (retired) physician who prescribed antibiotics for many conditions and his patients did well. There are some who prescribe antibiotics for Rheumatoid Arthritis as well, and again, their patients seem quite pleased with the results. I don't think that denying antibiotics to patients who may benefit from them is the answer, particularly derivatives of tetracycline.

Antibiotic resistant bacteria grow because of the use of antibiotics, they are just growing faster than they would if they weren't so widely used. IMO, the biggest waste of antibiotics is when a doctor prescribes them for a condition that is clearly viral. The resistant bacteria are also increasing because people don't finish their antibiotic prescriptions. Finally, (according to my microbiology professor several semesters ago) the biggest use of antibiotics is in animals raised for food. If we as a society really wanted to help decrease antibiotic resistance, we'd all stop eating animal products.

I think that the results of the study done with Rifampin and Doxycycline were just as valid as those from the Axona study based on the numbers, so, I don't consider it to be experimenting just for the heck of it. These antibiotics helped some people with AD. For my ADLO, the fact that the side effects are known and the drugs have been around for a long time is really important to me. I understand your concerns about the contribution it could make to antibiotic resistant bacteria for public health, but my biggest concern is helping my Grandma and based on the superbugs I've read about, I really don't think that rifampin or doxycycine resistance is an issue. And, again, even if it is, my bigger priority is my ADLO.

I am sorry that your friend's daughter died and I understand your thoughts on the cause of her death.

I guess we'll just have to agree to disagree on this one.

I originally posted the article because I thought it was both interesting and hopeful and I am hoping to find a physician who will try these antibiotics for my ADLO. And, again, if anyone knows a progressive physician in the continental United States who prescribes antibiotics for conditions other than routine bacterial infections, I'd really appreciate it if you'd either post the contact information for that doctor, of if you'd prefer, I'll post my email address.

jellybeans, the idea that AD might be linked to infections of various types is not new. There have been quite a few studies on the use of different types of antibiotics to try to treat it. One trial will produce results that appear promising, but the findings aren't reproducible when they run another trial. That's happened over and over again.

Just like many AD drugs have appeared to be beneficial in Phase II, and then found not to be in Phase III.

One of the biggest problems is that we don't know how to determine whether AD patients are actually being helped. Often, the initial studies will use just a handful of simple neuropsych tests to evaluate efficacy. When the drug progresses to Phase III, they'll start using a much larger battery of tests. And it's often the addition of more types of tests that reveal the patients aren't actually being helped in any meaningful sense, as much as it's the larger study population.

The antibiotic study used a single test -- ADAS-cog -- to evaluate efficacy. The ADAS-cog measures cognitive abilities in memory, language, orientation, and praxis -- things like word recall and word recognition, questions on where the patient is physically located, and whether he knows the time and date. It's sort of an expanded MMSE, with a possible score of 70 instead of 30. Differences detected by the ADAS-cog may not be at all discernible to the caregiver, who sees what AD is doing to the loved one's daily ability to function.

And when they say that the antibiotic group showed "significantly" less decline, they don't mean that the results were WOW!!!, they mean the results were statistically significant, based on the definition of statistical significance that they chose to impose. The smaller the number of patients, the less reliable the statistical analysis. Their data showed a great deal of variability.

The Axona trials (there have been several) not only used more patients, but also got better results, i.e., a considerably larger differences (roughly a factor of two) between the ADAS-cog scores of the treatment and placebo groups over a shorter treatment period, and much tighter clustering of the data points.

Perhaps much more importantly, the Axona trials have utilized not only ADAS-Cog, but also other tests, such as ADCS-CGIC. CGIC is used to assess meaningful clinical change over time. Unlike ADAS-cog, CGIC looks at the patient's overall function in the cognitive, behavioral and functional activity domains. And it utilizes input from the caregiver as well as assessment by the clinician. To me, this is very important. ADAS-cog is based on what the patient does on that one day he's sitting in the research facility, interfacing with the clinician. You can get improvement in ADAS-cog over time just because the patient becomes more comfortable with being at the research facility. CGIC looks at what the patient is like over the entire course of the study, including what he's like at home.

I would note another, very major difference between the Axona trials and this one: Axona was predicted to work on the basis of a specific mechanism, and one for which there is a great deal of ancillary evidence -- including studies in humans with Axona other than just the one you're referencing, as well as studies in a number of model systems, and studies on ketone body therapy in general. So far, the results of all the studies done on Axona have been consistent with the predicted mechanism. For example, improvement in cognitive function correlated with serum ketone body levels, and also correlated with relevant genetic information, such as APOE4 status.

The antibiotics were also predicted to work on the basis of a specific mechanism -- i.e., the eradication of the Chlamydia pneumonia infection. However, this study clearly showed that if there were any benefits, they were not due to Chlamydia eradication. Which raises serious doubts about whether the treatment actually was beneficial.

The fact that doxycyclin is used for a wide range of infections does not minimize the problem with using it for non-infectious purposes -- if anything, that makes it even worse. My point was not that these drugs might be needed to fight bioterrorism, but rather that they are needed to fight very serious diseases, some of which are currently pandemic. These drugs are supposed to be prescribed for infections which are known to be susceptible to them, and that's all they should be used for, unless and until larger studies using a much larger battery of neuropsych tests show that they actually are effective for AD.

You may disagree with me, but the experts at the CDC and WHO don't.

JAB,
Thank you again for sharing your opinion as well as your knowledge on this subject.
I think that we could go back and forth on this subject for pages and pages and we'd still have differing opinions. So, again I'll just agree to disagree with you and continue my search for a doctor.

For those interested in the tragic story of the young woman who died of a strep infection while vacationing in Hawaii, I think this is it:

"While we were on the last leg of our fight to Hawaii, Diane passed away. The doctors said that she had a strep infection and toxic shock.
Diane and Debbie had gone to Sea Life Park Saturday morning and swam with the dolphins. She had the time of her life. It was the main thing that she wanted to do more than any other while in Hawaii and had a fun. On the way home, she started throwing up. Diane and everyone thought it was the flu, and gave her medicine for it, as well as Gatorade and broth. She took a bath and went to bed. Just a couple of hours later, she was having difficulty breathing and they rushed her to the hospital. In two hours, she crashed the first time. The doctor thought she would live 3 hours. She made it 27 hours, and gave it every fight she could."

http://thealzheimerspouse.com/...hp?DiscussionID=2821
http://thealzheimerspouse.com/...hp?DiscussionID=2805
http://thealzheimerspouse.com/...hp?DiscussionID=2882

Jellybeans, please be sure that you actually are aware of the potential side effects, and have also considered possible drug interactions.

Generally speaking, side effects are studied in young, healthy adults, who are being prescribed only one antibiotic at a time. After the systematic safety studies, other side effects that may develop in other patient populations may or may not be reported, anecdotally. It is difficult to extrapolate those findings to elderly people suffering from dementia -- i.e., whose central nervous system isn't functioning well to begin with -- and who probably have decreased kidney function and also probably have comorbidities, and who are being given two antibiotics concurrently.

Rifampin has been shown to produce liver dysfunction. Fatalities associated with jaundice have occurred in patients with liver disease and in patients taking rifampin with other hepatotoxic agents.

Frequent side effects include mental confusion, behavioral changes, inability to concentrate, visual disturbances, and dizziness. Infrequently, psychoses have been reported.

Rifampin is known to induce certain cytochrome P-450 enzymes. Administration of rifampin with drugs that undergo biotransformation through these metabolic pathways may accelerate elimination of coadministered drugs. Rifampin has been reported to accelerate the metabolism of the following drugs: anticonvulsants (eg, phenytoin), antiarrhythmics (eg, disopyramide, mexiletine, quinidine, tocainide), oral anticoagulants, antifungals (eg, fluconazole, itraconazole, ketoconazole), barbiturates, beta-blockers, calcium channel blockers (eg, diltiazem, nifedipine, verapamil), chloramphenicol, clarithromycin, corticosteroids, cyclosporine, cardiac glycoside preparations, clofibrate, oral or other systemic hormonal contraceptives, dapsone, diazepam, doxycycline, fluoroquinolones (eg, ciprofloxacin), haloperidol, oral hypoglycemic agents (sulfonylureas), levothyroxine, methadone, narcotic analgesics, nortriptyline, progestins, quinine, tacrolimus, theophylline tricyclic antidepressants (eg, amitriptyline, nortriptyline) and zidovudine.

Rifampin has been observed to increase the requirements for anticoagulant drugs of the coumarin type. In patients receiving anticoagulants and rifampin concurrently, it is recommended that the prothrombin time be performed daily or as frequently as necessary to establish and maintain the required dose of anticoagulant.

Diabetes may become more difficult to control.

A number of other drugs has been shown to increase the blood concentrations of rifampin.

Concomitant antacid administration may reduce the absorption of rifampin.

Rifampin can also interfere with standard assays for vitamin B12 and serum folate. (It becomes increasingly important to be able to monitor these in the elderly and/or demented patients.)


As far as I can tell, the AD study you are relying on involved administration of twice as much doxycyclin as is normally prescribed (in addition to the rifampin), so please take that into account when evaluating potential problems from this antibiotic.

Frequent side effects include dysphagia (swallowing problems) -- which, by the way, usually develops in AD patients; nausea, vomiting, anorexia (another serious, frequent symptom of AD itself), diarrhea, enterocolitis and inflammatory lesions in the anogenital region. Infrequent side effects (again, at a normal dosage) include esophagitis and esophageal ulcerations.

Doxyclyclin will depress plasma prothrombin activity, so patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage.

Absorption of tetracyclines is impaired by antacids containing aluminum, calcium, or magnesium, and iron-containing preparations.

Barbiturates, carbamazepine, and phenytoin decrease the half-life of doxycycline.

The concurrent use of tetracyclines and methoxyflurane has been reported to result in fatal renal toxicity.

Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including doxycycline, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.

Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. Patients apt to be exposed to direct sunlight or ultraviolet light should be advised that this reaction can occur with tetracycline drugs, and treatment should be discontinued at the first evidence of skin erythema. (That happened to my sister, by the way. She got a severe sunburn -- badly blistered -- from sitting less than fifteen minutes in a car with the window rolled down.)

Swarfmaker-was there a reason to open fresh wounds by posting about the tragic death of the young woman in Hawaii. That information was posted with great concern by caring people on a special site meant to be read by folks who knew the girl and her mother. Just because the site is accessible doesn't mean it should be exploited

JAB,
Thanks, I did read about all of the side effects and interactions. I'd never order the meds from an online site and hope that they were the correct prescription or anything. I'd only do this under the supervision of a physician who prescribed the meds so that all of her blood tests (liver function, pro-time, etc) could be followed carefully.

They're doing another follow-up study comparing patients just taking one or the other antibiotic as well as patients taking both.
http://clinicaltrials.gov/ct2/show/NCT00439166

And, JAB, I really did appreciate the information you provided. I hope it came through that way in my posts. (If we were speaking instead of typing and reading, you would have heard my sincere gratitude). I definitely don't take any of it lightly- it took me over a year to let my Grandma's cardiologist put her on Lipitor. But, despite all of the potential side effects with Doxycycline it really is a generally well tolerated medication and with all of the penicillin related allergies, I have to believe that tons and tons of AD patients have taken tetracycline deravatives without a higher incidence of side effects (otherwise, I think they'd have been reported). Most of the side effects can be prevented (sunscreen, taking it with lots of water and not laying down for 30 minutes after taking it) or monitored for carefully. Rifampin seems to be something that again, serious side effects can be monitored for.

I gave some thought about trying to get my ADLO in this new study, but then reality set in.
I know my Grandma would not participate in the MMSE AT ALL, and she's probably too old for them to want to take her anyway and I don't know if they'd take someone from the US anyway. The only plus I had going for me was that it's not that far away.

quote:

I gave some thought about trying to get my ADLO in this new study, but then reality set in . I know my Grandma would not participate in the MMSE AT ALL

jellybeans, you wouldn't want your Grandma to have lumbar puncture, either.

This is interesting. It's about Parkinson's disease. We've often discussed the possibility of "environmental factors"...

Parkinson’s Researchers Focus On Chemical From Soil Bacteria
ScienceDaily (Oct. 6, 2009) — A chemical produced by common soil bacteria may kill neurons that produce dopamine, according to a study publishing Oct. 6. Dopamine neuron demise leads to the hallmark symptoms of Parkinson’s disease, a movement disorder affecting some 1 million Americans... “The data, so far, are seriously important, at best, and, at least, intriguing. By no means do we feel this is anything of a conclusive nature, yet.”... The research focuses on a chemical produced by a type of streptomyces, a bacterium frequently found in dirt and a top producer of antibiotics. This chemical, which the UA researchers say they believe is unknown to science, is likely produced by the bacteria as a secondary metabolite... “Without having the compound purified, we don’t know whether or not the amounts people would be exposed to in a lifetime would be sufficient to cause problems. It could be huge. It could be nothing. The jury is still out at this point.” The UA research indicates the chemical may be causing the death of the dopamine producing neurons by disrupting a system that acts as cells’ “garbage disposal,”... Left unchecked, one misfolding of a protein can lead to more and, eventually, cause an aggregation, or clumping, of proteins. This aggregation can lead to neuron malfunction or cell death...
http://www.sciencedaily.com/re.../10/091006093725.htm

One statement caught my attention, "The research focuses on a chemical produced by a type of streptomyces, a bacterium frequently found in dirt and a top producer of antibiotics" Hmmm... I have to wonder. Is this saying that this bacteria is used to produce antibiotics? Does it also imply that this "secondary metabolite" may be IN antibiotics created using this bacteria?

Scientists Remove Amyloid Plaques From Brains Of Live Animals With Alzheimer's Disease
ScienceDaily (Oct. 15, 2009) — A breakthrough discovery by scientists from the Mayo Clinic in Jacksonville, FL, may lead to a new treatment for Alzheimer's Disease that actually removes amyloid plaques — considered a hallmark of the disease — from patients' brains... Das and colleagues made this unexpected discovery when they initially set out to prove that the activation of microgila trigger inflammation, making the disease worse. Their hypothesis was that microglia would attempt to remove the plaques, but would be unable to do so, and in the process cause excessive inflammation. To the surprise of the researchers, when microglia were activated by IL-6, they cleared the plaques from the brains...
http://www.sciencedaily.com/re.../10/091015091602.htm

My little prediction: They will find something like this that does work (clearing the AB plaques), but it won't completely stop the disease. I think they will find that the AB is a symptom of another underlying process. Why do I think this? If you look up the research on these AD research mice, you will find that feeding them curcumin also was able to clear the AB plaques. If this translates to humans, then all of those people taking curcumin in the same relative quantity fed to the mice should be free from AB plaques. Has it worked?

Hello, forum newcomer here

My mom has both Alzheimers and Parkinsons, as well as a suprapubic catheter which lands her in the doctors office with loads of bladder infections. This March she was diagnosed with MRSA in her bladder, in response to which her regular GP suggested keeping moms fluid intake as high as we could. Went to a nurse practitioner two weeks ago as the regular GP was away, and the NP gave mom doxy for the MRSA. We have witnessed cognitive improvement with mom during the course of this treatment. The improvement was greater than that which normally accompanies the resolution of the bladder infection. I don't expect the improvement to be long lasting but thought it was interesting, upon reading this thread.

pearlygirl55
Have you considered having any amalgam fillings replaced, and following up with a heavy metal detox? Amalgam (mercury) is one of the leading causes of both chronic UTIs and neurodegenerative diseases (ie. Alzheimers and Parkinsons).

Hi Walt!
Thanks for the suggestions. I'm not sure if they would be able to remove moms fillings since it is so difficult to predict when she might have the ability & inclination to hold her mouth open for the dentist. having said that, she *does* think her dentist is "cute" and would certainly do better for him than she does for myself and her other daily caregivers.
Is there any point to do the heavy metal detox when someone still has these metal fillings in their teeth?
Thanks for the suggestion, hope you are having a great day

quote:

Originally posted by pearlygirl55:
Hello, forum newcomer here

My mom has both Alzheimers and Parkinsons, as well as a suprapubic catheter which lands her in the doctors office with loads of bladder infections. This March she was diagnosed with MRSA in her bladder, in response to which her regular GP suggested keeping moms fluid intake as high as we could. Went to a nurse practitioner two weeks ago as the regular GP was away, and the NP gave mom doxy for the MRSA. We have witnessed cognitive improvement with mom during the course of this treatment. The improvement was greater than that which normally accompanies the resolution of the bladder infection. I don't expect the improvement to be long lasting but thought it was interesting, upon reading this thread.

Hello and welcome
Are you talking about cognitive improvement relative to the time prior to the infection or congnitive improvement relative to the time during the infection? One would expect that if she declined during her infection that she'd improve as her infection healed. But, if she improved to a point that preceded her infection, that would more supportive of Doxycycline being helpful for AD.

I'm no fan of mercury amalgam fillings, but removing them may expose a person to more mercury than leaving them in place. Besides, metallic mercury probably isn't as toxic as we are being lead to believe. It seems that mercury containing chemicals are what are truly toxic, and the human body does not create them. Bacteria does this, and not the bacteria normally present in the human body.

There may be ways to remove mercury from the body without resorting to removing fillings. Look for "mercury chelators". I think malic acid is one. Cilantro has been mentioned. There is some concoction people have been giving autistic children to remove mercury acquired from vaccination.

Pearlygirl, hi, welcome to the forum.

The claim that "amalgam is one of the leading causes of both chronic UTIs and neurodegenerative diseases" is, I think, a tad bit of an over-statement.

As in, no one has established that mercury is a possible risk factor for AD, let alone a leading cause.

As for it being associated with UTIs, I just did a search for:

mercury "urinary tract infection"

on PubMed, and got two hits, neither of which was relevant.

Swarfmaker is quite right, that removing mercury amalgam fillings will expose a person to more mercury than leaving them in place.

A number of heavy metals -- copper, iron, and zinc -- have been implicated in Alzheimer's since higher than usual levels are found in AD brains. (The same cannot be said for mercury.) Chelation therapy is being studied, but so far, there has not been any success of which I'm aware.

Hello and welcome
Are you talking about cognitive improvement relative to the time prior to the infection or congnitive improvement relative to the time during the infection? One would expect that if she declined during her infection that she'd improve as her infection healed. But, if she improved to a point that preceded her infection, that would more supportive of Doxycycline being helpful for AD.[/QUOTE]

Sorry to have been so long in responding; mom has had pneumonia but is much better now.

She definitely improved to a point that preceded her infection, then tapered down again a few days after she stopped taking the doxy. I've started her on cinnamon capsules and apple cider daily, so we'll see how that goes.

Thanks for your reply.
I'm glad your Mom is doing better with her pneumonia.