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Ponstel (mefenamic acid) trial
Dr Chris
Posted: Saturday, June 9, 2018 8:41 AM
Joined: 6/9/2018
Posts: 2


I am a close to retirement medical provider in Ohio.  I have worked with Alzheimer’s patients for many years, and have seen very little improvement when using the two main prescription medications during the early stages of Alzheimer’s.

My father died of Alzheimer’s disease several years ago and my mother started showing some short term memory impairment about a year ago. I simply was not going to sit there and watch her decline as I did with my dad.

I had read about trials in England using the already FDA approved drug Ponstel, whose generic name is mefenamic acid. This NSAID drug is in the same class of medications as Motrin and Aleve.  It has vastly superior anti-inflammatory qualities in the brain compared to other NSAID drugs, as it crosses the blood brain barrier much easier.

As it is also useful for arthritis, we stopped Mom’s Aleve for 10 days. She was given Ponstel, tapering up very slowly from 50 mg up to 250 mg over a period of four days, to make sure she would tolerate it well.  She did.  She then got the full strength of 250 mg for seven days. 

I can honestly tell you that she has been very sharp mentally since the completion of her trial. Coincidence, who knows... too early to tell.

The drug is in various clinical studies here in the USA, and if the FDA approves it for treatment of Alzheimer’s disease, the price will go up two thousand percent, you can be sure of that. The drugs in this class have a slight risk of cardiovascular issues in the elderly. If your physician will prescribe it, be sure your loved one takes it with a full meal.  A one-week trial (250 mg per day) is all that is required. Your loved one does not need to take it every day perpetually.

I thought I would share my experience with you, as it might be an option for you to consider.

Here is a link to one of the studies done in England.

https://www.upi.com/Health_News/2016/08/11/Anti-inflammatory-drug-shows-promise-for-Alzheimers-disease-treatment/9711470920741/


Larrytherunner
Posted: Monday, June 11, 2018 5:22 AM
Joined: 2/26/2016
Posts: 171


Thanks Dr Chris for your info. Another member Markus 8174 has also written in the Clinical Trials section about getting mefenamic acid for his wife, and his wife has been getting positive results.

 

I am a true believer that neuro-inflammation drives Alzheimer's. There may be many factors that start the inflammation process (beta amyloid, various toxins, aging, lack of sleep, etc) but the only effective treatment so far is treating the inflammation caused by the brain's immune system.

 

I myself have been taking the anti-inflammatory drug montelukast (Singulair) for more than two years. It is not an NSAID but works in a different way, by blocking inflammatory leukotrienes from entering leukotriene receptors within the brain and other organs throughout the body. I started taking this drug after reading about Dr Ludwig Aigner's research in Austria in 2015. 

 

After I started taking this drug, my extreme mental fatigue and occasional confusion disappeared after one week. I now take 20 mg twice a day.

 

It is quite possible that both medications can be effective in treating Alzheimer's. I think that the montelukast advantage is that it has been proven very safe for long term use. There are no cardiovascular warnings, and there seem to be no serious side effects for adults. Also the price is cheap and unlikely to rise significantly because there are a large number of manufacturers importing this drug into the US. 

 

I am now 70 years old, retired from the US government and living in Ghana. I don't have any problem getting montelukast because anyone can buy it here without a prescription. In the states, however, it is a different story. Many people have posted to me that they want to get it but can't get a doctor's prescription. I would be interested to know how a person can get prescriptions for mefenamic acid or montelukast for treatment of Alzheimer's/dementia in the states. I am hearing that it is very difficult to do.

 

A small Canadian biotech company is sponsoring a phase 2 clinical trial on montelukast under the supervision of the Canadian government.

 

https://globenewswire.com/news-release/2018/01/24/1304269/0/en/IntelGenx-Initiates-Phase-2A-Montelukast-Versafilm-Clinical-Trial-in-Alzheimer-s-Patients.html

 

https://clinicaltrials.gov/ct2/show/NCT03402503

 

Here are some recent informative posts on the Clinical Trials board: 

"Montelukast's (Singulair) Unexpected Benefits"

"Georgia physician - high success rate with montelukast"

"Fenamate NSAID (Jan 22, 2018) by Markus 8174

 

Thanks for informing us that there are possible effective treatments available now, and we don't have to wait years for Big Pharma to come up with with expensive treatments that might not be effective or may cause more harm than good.


Dr Chris
Posted: Monday, June 11, 2018 4:20 PM
Joined: 6/9/2018
Posts: 2


Some psychiatrists believe that many types of mental illness, such as depression, bipolar, etc... are based upon an inflammatory response.   Thanks for posting about Singulair.
markus8174
Posted: Sunday, July 1, 2018 10:49 AM
Joined: 1/25/2018
Posts: 530


My ears were burning so I knew someone had mentioned me in a post. My DW is still taking meclofenamate (similar drug to ponstel) with fair results. The gains we achieved when I first started this med are beginning to fade. She takes 100mg twice daily. I have to place the med in enteric coated capsules since she does not tolerate them from GI upset. I'm sorry to see the gains we achieved slipping away, but I don't know that it is a loss of effectiveness of the fenamate med. I think it may be her illness has progressed to the point that Aricept and Namenda are no longer meeting the need. I know those meds don't treat the disease process, but just mask the mental decline for a while, but I had hopes the meclofenamate would at least arrest the progression for longer than we have seen. My final "Hail Mary" is increasing her Montelukast. Our doc has written for 10mg/bedtime. I can't get her to write for a higher dose so I'm shopping for one of those sketchy online pharmacies that don't require a Rx to buy non-controlled meds. It's worrisome, but we don't have much to lose at this point in her disease. If she continues at the rate she is declining, she won't remember who I am by the end of August.
Lane Simonian
Posted: Monday, July 2, 2018 9:32 AM
Joined: 12/12/2011
Posts: 4545


This is exactly what I have read, too.  If you block or inhibit the pathways leading to oxidation and inflammation (or remove inflammatory proteins themselves) with anti-inflammatory medications then you may help at least delay the onset of Alzheimer's disease and slow its progression very early on. 

The problem, however, later is not so much that microglia fail to remove amyloid plaques (which by limiting the formation of hydrogen peroxide may actually be doing some good), the problem is that anti-inflammatory drugs fail to reverse the oxidative damage that has already been done to the brain and to a large degree fails to prevent further damage.

http://www.jbc.org/content/280/43/35789.abstract

Receptor overactivation (g protein-coupled receptors, receptor tryosine kinases, ionotropic receptors) leads to protein kinase C activation, NMDA receptor activation, peroxynitrite formation, DNA damage, activated microglia, glutamate release, more NMDA receptor activation, and more peroxynitrite formation.  But by inhibiting the transport and removal of glutamate, peroxynitrite can lead to the progression of Alzheimer's disease even when microglia activity (the brain's immune cells) declines. Removing peroxynitrite early seems to lead to some improvements in cognition early in the disease that are sustained, and seems to slow down the later progression of the disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729264/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/ 

 


dolor
Posted: Tuesday, July 3, 2018 7:34 AM
Joined: 11/9/2017
Posts: 308


I've taken Advil regularly for other reasons and today will start to take it daily.  Will search around for a recommended dose. I'm sure it will aggravate my stomach and the ulcers my dr is convinced I must have. Oh well. 

I clearly remember my mom saying she "couldn't take any NSAIDS." I wish I could remember exactly when she said it. She said they irritated her stomach, but now I'm going to need to find out how long this research has been around...


markus8174
Posted: Thursday, April 25, 2019 2:01 PM
Joined: 1/25/2018
Posts: 530


dolor- advil is not effective for treatment of Alzheimer's. The only NSAIDs that has shown documentable improvement is those of the "fenamate" class: flufenamic acid, meclofenamic acid, mefenamic acid, and tolfenamic acid. The only drug names I've found for this class of NSAID are Ponstel, and Meclomen. I wouldn't risk the possibility of a GI bleed, kidney and liver injury, and increased risk for a heart attack on any of the other NSAID drugs. For this to be useful for dementia it needs to be taken daily at a therapeutic dose.  Most NSAIDs are only recommended for short term use due to these risk factors.