PYRITINOL

Pyritinol versus Hydergine

Alzheimer's Research (United Kingdom) , 1996, 2/3 (79-84)

In this multi-center trial, 100 patients with the diagnosis of senile dementia of the Alzheimer's type (SDAT) of mild to moderate severity were randomly divided into two treatment groups and, following a placebo wash-out phase, were administered either pyritinol or Hydergine for 12 weeks in a double-blind, randomized parallel comparison. Two measures of cognitive functioning were employed to assess treatment effects. The results indicated that treatment with pyritinol was associated with a significant and continuous improvement in cognitive functioning over the course of the study while treatment with Hydergine was associated with a more modest improvement that tended to plateau early in the treatment phase.

Pyritinol and Phosphatidylserine

Ann. New York Acad. Sci. (USA) , 1993, 695/- (327-331)

Forty patients with probable Alzheimer's disease were selected from a pool of 80 patients and assigned to four groups. Each received either social support, cognitive training only, or cognitive training in combination with pyritinol or phosphatidylserine. Treatment duration was 6 months. Before and after treatment the patients underwent neuropsychological testing as well as measurement of the regional cerebral metabolic rate for glucose using positron emission tomography (PET) and 2(18F)-fluoro-2-deoxy-D-glucose (FDG). Before treatment, the groups were comparable in respect to resting and activated glucose pattern achieved by a visual recognition task. They did not differ in scores of a neuropsychological test battery.

After the treatment period the group with cognitive training plus phosphatidylserine showed a significant glucose enhancement during the stimulation tasks in various brain regions, and an improvement in cognitive functioning compared to other groups. The group with cognitive training plus pyritinol had better stimulation effect than that of the social support group, indicating that a combination of cognitive training and pharmacological intervention was superior than that of cognitive training alone.

Pyritinol, Alzheimer's and Stroke

Fischhof P.K.; Saletu B.; Ruther E.; Litschauer G.; Moslinger-Gehmayr R.; Herrmann W.M. Psychiatric Hospital, tomography scans and electroencephalographic (EEG) findings

In a 12-week double-blind treatment phase, either 200 mg pyritinol dihydrochloride-monohydrate or placebo was given four times daily. Confirmatory statistics included item 2 of the Clinical Global Impression, the total score of the Short Cognitive Performance Test (Syndrom Kurz Test) and the factor "cognitive disturbances" of the Sandoz Clinical Assessment Geriatric scale. In addition, data on tolerance, of EEG brain mapping and of a responder analysis were evaluated based on descriptive statistics. The therapeutic efficacy of pyritinol was clearly demonstrated by confirmatory analysis as the drug was statistically significantly superior to placebo in all 3 target variables. The clinical relevance of the outcome was underlined by the analysis of the descriptive variables and by the convergence found at the different observation levels.

The EEG mapping demonstrated significant differences between placebo and pyritinol, with the latter decreasing slow and increasing fast alpha and beta activity, which reflects improvement of vigilance. Based on the results of this trial, it can be accepted that the therapeutic effect of pyritinol is superior to placebo in patients with mild to moderate dementia of both degenerative and vascular etiology.

Pyritinol and Chronic Organic Brain Syndrome

Med. Klin. (Munich) (West Germany), 1978, 73/31 (1117-1121)

161 patients with the chronic organic brain syndrome (average age 64 years) were treated with various oral doses of pyritinol for various periods of time. Statistical analysis of the data by means of 'Konfigurationsfrequenzanalyse' showed that the success rate of treatment increases significantly with increasing dose and duration of the treatment. This means that the recommended daily dose should be exceeded if . . . there is no immediate clear improvement in the condition (for example, at the start of treatment and in severe cases or in hospitalized patients). From the point of view of method this study shows that a retrospective analysis of a group of patients treated in a clinic can also provide interesting results and appropriately supplement controlled studies.

Pyritinol and Head Injuries

Kitamura K., Dept. Neurosurg., Neurol. Inst., Med. Coll., Tokyo JAPAN
J. Int. Med. Res. (England) , 1981, 9/3 (215-221)

Two hundred and seventy patients suffering from the sequelae of different forms of brain injury have been treated orally with pyritinol, 200 mg three times a day, for a period of six weeks. It has been shown that, compared with placebo therapy, pyritinol produces statistically significant improvement in the clinical and psycho neurological manifestations. It is concluded that pyritinol is a drug of therapeutic benefit in the treatment of the sequelae of cerebral trauma.

Pyritinol and Dementia

Pharmatherapeutica (England), 1980, 2/5 (317-322)

A double-blind, placebo-controlled trial was carried out on 40 patients suffering from moderately advanced dementia. The patients were allocated randomly either pyritinol (800 mg daily) or identical placebo for three months. Assessments using a modified Crichton Geriatric Behavioral Rating Scale were made pre-treatment and monthly up to three months, and then at follow-up at six months. Patients on pyritinol showed significantly higher levels of improvement than did those on placebo. Laboratory tests conducted throughout remained within normal limits for both groups.

Pyritinol Hydrochloride for The Treatment of Vertigo

Ouest Med. (France) , 1976, 29/1 (43-46)

In most cases of vertigo from vasculo tensional disorders of the labyrinth, the trouble in the vestibular cells is not solely due to spasm or vascular atheroma. An important part is played by hypoglycoxydosis, showing itself in the neuro elements of the vestibule. In assisting the passage of glucose across the blood brain barrier, pyritinol allows a better utilization of glucose by the differentiated cells of the vestibule. This is how the drug helps in the treatment of vertigo, by correcting the associated hypoglycoxydosis. In a clinical experience with 60 cases of vertigo, the author obtained a cure rate of 83.33%, accompanied by an improvement in the patient's mental and social state. The drug was tolerated well by patients of all ages.

Neurologic Diseases in Children

Cs.pediat. (Czechoslovakia) , 1974, 29/10 (562-564)

Forty-one patients (28 boys and 13 girls) with various diseases of the central nervous system were treated by oral administration of pyritinol in addition to the usual therapy. Before, during and after termination of treatment, neurological, psychological and EEG examinations were made to evaluate the effect of pyritinol (Encefabol Merck). The patients were divided into 4 main groups. In severe contusions of the skull with apallic syndrome (9 children), improvement was recorded in the majority, and marked improvement in one-third. In meningoencephalitis (8 children), treatment was successful in half the patients; in infantile cerebral palsy and malformations on the brain (19), treatment was successful in about one-third of cases. In minor disorders of the brain (5), the effect was smallest. According to these results, pyritinol treatment offers a certain contribution to treatment used in pediatric neurological practice.

Anaesthesia and Post-Anaesthesia Resuscitation

Anaesthesist (West Germany) Nov 1979, 28 (11) p530-2,

On the basis of good results in a pilot study of 40 patients who had undergone anaesthesia for various surgical operations, infusions of pyritinol was tested under controlled double-blind conditions on 60 further patients. Pyritinol 600 mg was infused immediately after anaesthesia. The aim of this study was to verify the favorable effect on the post-anaesthesia phase. It was shown that pyritinol significantly shortens the wakening time and, furthermore, positively influences the subjective feeling of the patients after anaesthesia.

Alcoholic Organic Brain Syndrome

Int. Pharmacopsychiatry (Switzerland), 1978, 13/3 (177-192)

The efficacy of EMD 21657, a derivative of a pyritinol metabolite, with regard to the improvement of the organic brain syndrome (OBS) of chronic alcoholics was investigated in a double-blind study utilizing clinical, psychometric and quantitative EEG evaluation. Nineteen patients received 3 x 300 mg EMD and 21 patients 3 x 1 dragee placebo for six weeks. The hospitalized patients were examined before as well as at the end of the second, fourth and sixth week of drug treatment. While the overall evaluation by the psychiatrist and patients at the end of the period of treatment did not show marked intergroup differences, the clinical global impression scale and the OBS rating scale demonstrated that both groups showed a significant reduction in OBS and improvement with EMD 21657 therapy was significantly superior to that with placebo.

Psychometric analysis also exhibited a significant superiority of EMD in regard to the general, associative, numeric and total verbal memory, concentration and attention variability. Psycho visual memory and the quantitative aspects of attention showed opposite findings. Flicker light fusion frequency, reaction time and after-image did not change significantly. The psychomotor activity improved significantly more with EMD than placebo; this was especially pronounced in the left hand. Affect and mood improved also more with EMD than placebo. Side effects were observed more frequently under active treatment and were characterized by temporary headaches. Power spectral density analysis of the EEG revealed in both groups a decrease of delta, fast alpha and beta activities and an increase in theta and slow alpha activity, but changes during EMD treatment more frequently reached the level of statistical significance than with placebo. The most consistent finding was the theta augmentation under EMD treatment.