This drug is receiving significant attention for disorders in neuroscience medicine.
A phase 2 clinical trial of dextromethorphan-quinidine (DM-Q) was published last fall in JAMA.
Here are the key design and results from this study:
Subjects: 220 subjects with a diagnosis of probable Alzheimer's disease with clinically significant agitation.
Randomization Design: This was a five week trial of 3:4 randomization to received DM-Q or placebo. Placebo subjects were re-randomized and enrolled in a 1:1 DM-Q versus placebo trial
Drug Dose Design: DM-Q 20mg-10mg daily for one week, then 20-10 twice daily for two weeks then 30mg-10mg twice daily for remainder of study.
Outcome: The primary outcome score was the agitation/aggression subscale score from the Neuropsychiatric Inventory. Active drug assignment reduced this score more than placebo (7.1 to 3.8 versus 7.0 to 5.3).
Adverse effects: Serious adverse effects were more common in active drug groups 7.9% versus 4.7% and included higher rates for falls, diarrhea and urinary tract infections.
The authors note in the discussion that the higher rate of falls may have been due to an imbalance of fall risk at randomization.
This is an important study of a novel treatment approach to agitation in the elderly with Alzheimer's disease. Current drug treatment approaches are limited and linked to significant side effects.
Phase 3 studies of this drug combination are recruiting at the present time.
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Readers can access the free full-text manuscript by clicking on the PMID link below.
Figure of dextromethorphan comes from a Wikipedia Creative Commons file authored by Benjah-bmm27.
Cummings JL, Lyketsos CG, Peskind ER, Porsteinsson AP, Mintzer JE, Scharre DW, De La Gandara JE, Agronin M, Davis CS, Nguyen U, Shin P, Tariot PN, & Siffert J (2015). Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia: A Randomized Clinical Trial. JAMA, 314 (12), 1242-54 PMID: 26393847
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