TABLE 72 Other Treatment Strategies

Super Memory Formula

Memory Loss Holistic Treatment

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DRUG

Dopamine precursors/agonists (clonidine, guanefacine, amantadine, bromocriptine) Selegiline

Hydergine, nicergoline Nootropics (e.g., piracetam, oxiracetam)

Neurotrophic factors (e.g., nerve growth factor) Estrogens

MECHANISM OF ACTION

Metabolic enhancement

May counteract atrophy of cholinergic neurones

May enhance cognitive function and exert neurotrophic and neuroprotective effects

EVIDENCE

Studies suggest largely ineffective

No adequate evidence of efficacy; see below for combination with vitamin E No adequate evidence of efficacy Non-specific effect on memory but no adequate evidence of efficacy in dementia Tested in small number of patients with limited success; no clinical trials Epidemiological evidence suggests possible benefit but intervention studies show no efficacy

Neuroprotection and cognitive enhancement

Enhance dopamine function

MAO-B inhibitor

NSAIDs

Vitamin E (with selegiline), Ginkgo biloba

Calcium channel blockers

May reduce inflammation associated with neurodegeneration

Antioxidants

Block increases intracellular calcium that may mediate cell death

Epidemiological evidence suggests possible benefit but intervention studies show no efficacy Vitamin E plus selegiline maintains activities of daily living and prolongs survival in the community but without measurable improvement in cognitive test performance;Ginkgo biloba used in Europe for dementia syndromes but evidence for its cognitive enhancing properties is weak and inconsistent May delay progression of memory impairment and onset of dementia but there is a lack of controlled data on efficacy

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