I was recommended to try Cerebrolysin by one of my friends. Apparently its effects on healthy individuals are really noticeable. It is generally well tolerated nootropic. Medical research documents on Cerebrolysin look very impressive. Luckily I can get it for a relatively cheap price, so I guess I will try it next month. The only disadvantage is the administration method. It has to be injected. However, intramuscular injections can be used for doses up to 5 ml (it's enough for healthy individuals). We all know that intramuscular injections are very simple...
Cerebrolysin®
A company called Ebewe in the Germanic country of Austria has developed and gained approval for their injectable product called Cerebrolysin® (CRB).
What makes CRB interesting is that it is specifically aimed at delaying the progression of AD; this is unusual in-itself because the current approved medications, (donepezil and memantine) are merely targeted at improving the symptoms and some of the disease outcomes.
CRB is also different because it can be considered to be the first natural approach to AD. CRB is peptide based, being very careful obtained by standardised enzymatic processes from purified brain proteins and aminoacids (of porcine origin).
CRB is designed to help support the function of neurons. This type of approach is known as neurotrophic and CRB being a neurotrophic factor appears to help support and maintain a number of neurons including those of serotonin, choline (related to Ach) and noradrenaline origin.
Action
What this means, is that CRB appears to be able to except a growth like factor on neurons, particularly those from the dorsal root ganglia. Plus, CRB appears to affect synaptic responses in the hippocampus, the region of the brain believed responsible for the deposit of memories. In other words, Cerebrolysin® helps to maintain and support these vital repair processes in the brain.
In addition, Cerebrolysin® has been shown to decrease amyloid-beta production in the brain. These are the so-called Alzheimer plagues that are seen in the post mortem examinations of AD autopsies. As these plagues are strongly correlated with the damage of AD, their control or reduction may be viewed as a highly significant benefit.
Furthermore, there is even some evidence that CRB can decrease the rate of apoptosis (the rate of cell death), a factor that could be linked to the slowing of the progression of the disease.
Clinical trials
Now that 80 trials have been completed on more than 5000 patients with AD, CRB can be considered to be well tested.
The studies highlight that those patients suffering from mild to moderate AD, that when treated with I.M. or I.V. infusions of CRB each day for 5 days a week, over a period of 4 weeks, that there was a significant improvement in cognitive measurements, even after just the first 4 initial weeks. What's more, Dr. E. Ruether, one of the doctors involved in the trials, noted that these improvements remained stable for up to 6-months- even after cessation of the therapy.
In more human terms this means that there are improvements in the activities of daily living, with the patients being able to do more by themselves, with far less assistance etc. Furthermore, when compared to the placebo patients in the trials, the CRB treated patients retained their improved cognitive measurements, even at month 7, whereas the placebo patients had clearly deteriorated during this same period.
Safety
To date, no known toxicity or safety concerns have been reported. Side effects during treatment have been rare and generally limited to dizziness, headache and heat sensations, although it is possible that these effects are related to the injection or I.V. being given "too quickly."
Potential contraindications appear to be limited to individual hypersensitivity, severe renal conditions and epilepsy.
Dosage
The normal dose pattern appears to be a 5 ml ampoule injected, (intramuscularly or intravenously) each day for 5-days (e.g. Monday-Friday) and repeated for a period of 4-weeks. Then after a 2-month period free from treatment the program is cycled again as necessary. Therefore, four packages each containing 5x 5ml ampoules are normally enough for 3-months at a time.
Summary
CRB is a unique departure for approved drugs for AD for the following reasons:
1. Firstly it is aimed at the prevention/ slowing the progression of the disease rather than alleviation of specific symptoms.
2. Secondly it does not merely improve Ach levels, but rather enhances overall neuronal condition.
3. Thirdly, it can be considered to be a more natural approach, because rather than the current drugs, it is formed from natural brain proteins.
4. It has far fewer side effects and contraindications than the existing therapies.
Overall, CRB has been shown to help modify the course of AD and delay its progression leading to a stabilising effect on AD patients.
All of this appears to have been achieved with very few side effects and contraindications which makes CRB a welcome addition to the armoury in the fight against the plague that is Alzheimer's disease.
References
1. Rockenstein E, Torrance M, Mante M, Adame A, Paulino A, Rose JB, Crews L, Moessler H, Masliah E "Cerebrolysin decreases amyloid-beta production by regulating amyloid precursor maturation in a transgenic model of Alzheimer's disease" J. Neurosci. Res. (2006) May 15;83 (7) 1252-61
2. Masliah E, Armasolo F, Veinbergs I, et al., "Cerebrolysin ameliorates performance deficits and neuronal damage in apolipoprotein E deficient mice." Pharmacol. Biochem. Behav. (1999), 62 (2): 00 239-245
3. Jonhagen ME, "Nerve growth factor treatment in dementia" Alzheimer disease and associated disorders (2000), 14: S31-38
4. Ruether E, Ritter R, Apecehea M, et al. "Efficacy of the peptide nootropic drug Cerebrolysin in patients with senile dementia of the Alzheimer type," Pharmacopsychiatry (1994), 27 (1), pp 32-40
5. Xiao S, Yan H, Yao P, "Efficacy of Cerebrolysin in patients with Alzheimer's disease" Clin. Drug Invest (2000), 19 (1): pp 43-53
6. Ruether E, Ritter R, Apecehea M, et al. "Sustained improvement in patients with dementia of Alzheimer's type 6-months after cessation of Cerebrolysin therapy" J. Neural. Trans. (2000), 107 pp 815-829
7. Bae CY, Cho CY, Cho K, et al. "A double blind, placebo controlled, multicenter study of Cerebrolysin for Alzheimer's disease" J. Am. Ger. Soc. (2000), 48 pp 1566-1571
8. Alvarez X, Moessler H, "Efficacy of Cerebrolysin in moderate to moderately severely Alzheimer's disease" In. Vellas B (ed), research and practice in Alzheimer's disease, Serdi, Paris (2001), pp 179-186
9. Ruether E, Husmann R, Kinzler E, et al, "A 28 week, double blind, placebo controlled study with Cerebrolysin in patients with mild to moderate Alzheimer's disease" Int. Clin. Psycopharm. (2001), 16 pp 253-263
10. Panisset M, Gauthier S, Moessler H, et al. "Cerebrolysin in Alzheimer's disease; a randomized, double-blind, placebo controlled trial with a neurotrophic agent" J. Neural. Transm. (2002)
11. Rainer M, Brunnbauer M, Dunky A, et al. "Therapuetic results with Cerebrolysin in the treatment of dementia" Wiener Medizinische Wochenschrift (1997), 147 pp 426-431.
12. Alvvarez XA, Cacabelos R, Laredo M, Couceiro V, Sampedro C, Varela M, Corzo L, Fernandex-Nopvoa L, Vargas M, Aleixandre M, Linarges C, Granizo E, Muresanu D, Moessler H, "A double blind, placebo controlled study of three dosages of Cerebrolysin in patients with mild to moderate Alzheimer's disease" Eue. J. Neurol. 2006 Jan 1;13 (1) 43-54