Comparison of teniloxazine and piracetam in alzheimer-type or vascular dementia

Abstract

In recent years, various pharmacologic approaches to improve the cognitive function of elderly patients with dementia have been proposed. These approaches are based on the observation that the drugs used act either directly or indirectly on neurotransmitters and their precursors. Recent studies have shown that teniloxazine, a new chemical entity, acts on specific neurotransmitters, inhibiting cerebral re-uptake of noradrenaline, blocking serotoninergic transmission, and restoring normal energy metabolism in the brain. This study compared the effects of teniloxazine and piracetam on the specific behavioral symptoms of Alzheimer-type or vascular dementia. The trial was conducted in six centers throughout Italy and included 117 patients (46 women and 71 men), aged 47 to 80 years, with Alzheimer-type degenerative dementia (62 patients) or vascular dementia (55 patients). Patients were randomized to receive either teniloxazine 80 mg twice daily (n = 57) or piracetam 800 mg twice daily (n = 60) for 3 months. Patients took tablets at 8 AM and 6 PM. The two drugs were similar in efficacy in terms of improvement in somatic and psychosensorial symptoms, and cognitive and behavioral performance, assessed with the Sandoz Clinical Assessment Geriatric Rating Scale ( P < 0.01, analysis of variance between times). Both drugs improved short-term memory. Scores on the Hamilton Rating Scale for Depression showed a larger reduction with teniloxazine (26.4%) than with piracetam (16.8%), indicative of a good improvement in the initial depressive symptoms. Few adverse events occurred (7 with teniloxazine and 5 with piracetam); 1 patient treated with piracetam did not show up for the last visit and was considered a dropout. Both drugs were considered therapeutically safe.