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    cyproheptadine
    periactin

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    Melatonin And Alzheimer's Disease (AD)

    Senile dementia is not always present in the old population. However, it does affect almost 50% of people over the age of 85 (Beal, 1994).

    It was shown that melatonin decreases with advanced age. Murialdo, et al., (1993) demonstrated that patients with higher scores on a mental exam also had higher melatonin levels. Healthy elderly people had double the amount of melatonin as compared to patients with Alzheimer's disease (Mishima, et al., 1994).

    Witting, et al., (unpublished data) found a positive correlation between the degrees of dementia and circadian disturbances. Several other studies also demonstrate that the degree of dementia is related to circadian rhythm disturbances.

    Reiter, et al., (1988), have shown that melatonin deficiency combined with reduced number of melatonin binding sites in the hypothalamus constitute another factor to the disturbances in circadian rhythm found in Alzheimer's patients.

    Nair, et al., (1986), suggest from their study that changes in plasma melatonin rhythm may be a useful indicator of brain aging in humans.

    In Alzheimer's patients, the 24-hour serum melatonin was lower than in the non-senile aged population.

    In my practice, I have used melatonin at doses of 3-6 mg. in the evening in Alzheimer's patients. In about 30% of my patients the symptoms of memory loss improved considerably and they scored higher on Mini Mental examination. I also used cyproheptadine at doses 0.5 mg. To 4 mg. nightly with similar results.

    I believe that more research is needed to determine the melatonin disturbances in AD and more trials are needed using either melatonin at different doses, or cyproheptadine, or the combination of both.



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