Alzheimer's: slowing the decline.

A naturally occurring compound named acetyl-L-carnitine may slow the worsening of dementia symptoms among people with Alzheimer's disease, a preliminary study suggests.

Researchers from 10 Italian hospitals found that year-long treatment with acetyl-L-carnitine improved overall attention span, long-term memory and verbal ability in 63 Alzheimer patients, with no serious side effects. In contrast, 67 Alzheimer patients receiving a placebo showed no such improvements, reports the team, led by Alberto Spagnoli of the Mario Negri Institute in Milan.

"Our findings should be considered preliminary but are encouraging," they conclude in the November NEUROLOGY.

All human cells make acetyl-L-carnitine. The Italian firm Sigma-Tau S.p.A. began selling the substance by prescription in Italy four years ago as a treatment for dementia. Some U.S. health food stores currently sell carnitine lacking an acetyl group as a general nutritional supplement. Previous laboratory and animal tests demonstrated that acetyl-L-carnitine can stimulate nerve cells to produce proteins and new cell membrane, and to release the neurotransmitter acetylcholine, Spagnoli's team notes.

Sigma-Tau's U.S. subsidiary has just finished enrolling 400 patients for a U.S. trial of acetyl-L-carnitine, says Susan Sauer of Sigma-Tau Pharmaceuticals Inc. in Gaithersburg, Md. The study, which the company expects to last one year, involves 27 Alzheimer's research centers across the nation. After the study's completion, the company plans to seek FDA approval to market the drug in the United States.

No drug therapy currently exists for Alzheimer's. Last March, an FDA advisory panel recommended against the approval of tetrahydroaminoacridine (THA), a potential Alzheimer treatment that inhibits the breakdown of acetylcholine (SN: 3/23/91, p.180). THA's developer, Warner-Lambert Co., is now amassing additional data on the drug.