Another one bites the dust

Actually, two more bit the dust. A collaboration between two of the world’s largest drug companies fell apart after years of Alzheimer’s research. Eli Lily, the lead company in the repeated trials to find someone, anyone, for whom their drug would produce a therapeutic effect, quit the search and published their story in the New England Journal of Medicine.

An interesting footnote about research in general-it’s rare for a big journal or any journal to publish negative results. But there is so much riding on the crusade for Alzheimer’s treatment that the failure was big news.
The clinical trials and the search for an effect of the drug at some stage of the illness (actually any stage of the illness) were fascinating to follow over the years. We are left with approved drugs showing little effect and one is based in a theory of not enough of a certain brain chemical and the other on a theory of too much of another brain chemical.

I’ve been involved with people with Alzheimer’s since before we knew what Alzheimer’s was and I have a hard time explaining the medications and their proposed benefits to patients and families. Luckily, by the time people start visiting the Fields, they’ve been through the confusion of the medications and reconciled themselves to living with the illnesses.

Since I know now that my hundred or so guests probably have one of several subtypes of dementia and the drugs are for the Alzheimer’s type, the discussions are even more inane.

So, we’ll double down, as the saying goes, and do more work on individual treatment plans, identifying stages and behaviors we can target for therapeutic involvement.

A word of caution to my fellow therapists in the field: in the moment, all therapeutic interactions have effects- music, art, etc.

However, it’s poor science, and reflects on us all, if you propose that your therapy changes the brain or the disease. Open SPECT scanners are irrefutable examples. You can see the effects of therapeutic activity on the brain, as different areas are enervated by the music, art, story-telling, piano playing (improvisation is more powerful than playing a memorized piece) etc.

The leap to lasting effect is a dangerous one.