The National Institute of Health is funding a study to test whether a generic medication will reduce agitation in Alzheimer’s patients. The drug is prazosin, a generic medication that controls high blood pressure.  Prazosin has been in use since the 1970s.  It is inexpensive, well tolerated by most people, and non-sedating.

Some people diagnosed with Alzheimer’s disease suffer from agitation. The agitation can take different forms, and often expresses itself in a combination of behaviors, including restlessness, sleep disruptions, angry outbursts, and irritability. These symptoms cause a great deal of distress to both the patients and their care givers. Being able to reduce agitation would lead to a better quality of life for both, and it would also facilitate better care and better functional status.

In a pilot study conducted in Seattle, 22 Alzheimer patients participated in a double blind placebo controlled study of prazosin. At the end of the 8 week study, those patients who received prazosin were measurably less agitated than those who received a placebo, as determined by 2 scales which measure anxiety and mood changes.

Physicians and researchers do not understand why Alzheimer’s patients are subject to increased agitation. One hypothesis is that the disease causes the brain to produce excess adrenaline. Prazosin blocks the brain’s receptors to adrenalin and it is thought that it may therefore reduce the excess adrenaline effects in the brain.

Many are excited by the prospect of an inexpensive, well tolerated drug with minimal side effects that might bring relief to agitated Alzheimer’s patients. Until now, physicians have prescribed medication that  reduces agitation in patients with psychiatric disorders. However, these drugs are often not effective for Alzheimer’s patients.  In addition, they can have significant adverse side effects, such as excessive sedation, symptoms similar to Parkinson’s disease, and increased risk of stroke.

As explained in a previous blog, in January the NIH announced funding of four different studies all aimed at understanding how to slow the progression  and reduce the symptoms of of the disease.  This study of prazosin is one of these studies.  It will be conducted at the University of Washington Alzheimer’s Disease Research Center over a  24 week  period.  There will be 120 research subjects accepted into the study. To qualify for inclusion, a person must have a diagnosis of probable or possible Alzheimer’s disease, episodes of agitation at least twice a week, and a caregiver who is with the person at least 10 hours per week and is willing to participate in the study.

The research participants will be divided into 2 groups. For the first 12 weeks, one group will receive prazosin (4 mg, twice daily) and the other group will receive a placebo. At the end of 12 weeks, all research subjects will receive prazosin for another 12 week period.