Are there doctors who use Methlyene blue for Alzheimer's treatment?

July 30, 2008 6:35 AM

I'm looking for a doctor (possibly within driving distance from Detroit), who might be comfortable talking about off-label treatments for Alzheimer's. Specifically, I'd like to get some qualified, knowledgeable info about Methylene blue. Thanks everybody.
posted by anonymous to health & fitness (5 answers total)

Rember is not the same as methylene blue. Although that study has been widely reported in the lay press, the results are preliminary, and have not been published in a peer reviewed journal. The drug is not yet available on or off label.

If you (or someone you know) want to try the drug, you'll need to enrol in one of the Phase III trials. Those trials don't sound like they have been approved yet, but they will probably be conducted in large hospitals with associated academic units studying Alzheimers.

You can ask your physician for a referral to a suitable centre.
posted by roofus at 7:21 AM on July 30, 2008

As a pharmacologist I will chip in my two cents from reading the article. (Previewing this, it is a bit rambling, sorry.) First, to claim that you work twice as well as cholinesterase inhibitors is not a great claim - they have a marginal effect. To work twice as well as cholinesterase inhibitors in phase II trials is even less significant - because of the nature of phase II trials this probably happens in about half of the cases of drugs that will never make it market.

The article has some moments of bad science or just bad phrasing. "The drug, Dr. Wischik said, was effective when it dissolved in the stomach, but was not effective when the drug was absorbed through the intestines." Since it works in the brain absorption is the issue for an oral dose. The intestines absorb - not the stomach. So they are probably saying the 100 mg dose didn't dissolve adequately in the stomach to be later absorbed through the intestines. Oh, well, I'm probably being picky about grammatical imprecision.

Considering the drop out rate between phase II and eventual approval, I'd put this about a one in ten chance it will be a useful drug for this condition. However, since it is already available, as you noted, it could be prescribed off-label. Chances are you are not going to find a physician who knows more about this - other than exceptional circumstances physician won't be following news from phase II trials. Which means you might be able to get a physician who would comment on this based on what you have.

I'm not sure what they meant by "He added that the drug used in his trial was "much purer" than the formulation currently available." This could be crucial as to whether you can use it off-label. Is it referring to potentially toxic adulterants? (something in the available formula that prevents you from taking more - rarely the case). Is it referring to dosage being higher? (In which case you can take more)

You might be able to link up with the phase III trials and enroll. Maybe that would be the best route - closely monitored for side effects and efficacy.
posted by dances_with_sneetches at 7:33 AM on July 30, 2008

Okay, re-reading this and taking into account what roofus said, this looks like one of the ingredients that make up methylene blue - that's where the purity comes in.
posted by dances_with_sneetches at 7:37 AM on July 30, 2008

I'm not sure what the difference is either, it might only be a modified release formulation. There must be some significant patentable difference, or there would be no commercial motivation for TauRX to do these trials.
posted by roofus at 7:55 AM on July 30, 2008

Prescribing medications off-label is a touchy subject, which might inhibit people from mentioning the names of specific physicians in public responses on AskMe. You might want to ask a mod to post a throwaway email account for people to contact you directly.
posted by googly at 8:55 AM on July 30, 2008