While Parkinson’s disease initially causes physical symptoms, issues with cognitive function often emerge later. According to Johns Hopkins Medicine, around 4 out of 5 Parkinson’s patients eventually develop dementia. This can lead to cognitive issues with problem-solving, communicating, concentration, and memory. A new study has found that a cough medicine commonly used in Europe may reduce these symptoms and improve the cognitive performance of those living with Parkinson’s disease dementia.
Could a Common Cough Syrup Help Protect Parkinson’s Patients from Dementia?
Dr. Stephen Pasternak first came across the cough syrup known as Ambroxol during his fellowship at the Toronto-based Hospital for Sick Children. There, it had already been identified as a Gaucher disease treatment, a rare genetic disorder caused by a GCase (glucocerebrosidase) deficiency. Ambroxol supports Gcase, an enzyme produced by the GBA1 gene. GCase levels are often low in Parkinson’s patients. When this enzyme isn’t working effectively, waste begins to build up in brain cells, resulting in damage. Dr. Pasternak has now decided to find out if using Ambroxol to boost GCase levels in Parkinson’s patients can prevent the development of dementia.
Along with fellow researchers from Lawson Research Institute, Dr. Pasternak conducted a 12-month clinical trial to find out if Ambroxol could safely be used to slow Parkinson’s disease-related dementia. The cough medicine has already been used for decades in Europe and is considered very safe and effective. The trial followed 55 patients diagnosed with Parkinson’s disease dementia, monitoring their psychiatric symptoms, memory, and a blood marker associated with brain damage called GFAP. The participants were split into two groups, with one group given Ambroxol daily and the other given a placebo. According to Dr. Pasternak, “Our goal was to change the course of Parkinson’s dementia. This early trial offers hope and provides a strong foundation for larger studies.”
Findings of the Clinical Trial
The trial found that Ambroxol was well-tolerated by those who took it and reached therapeutic levels inside their brains. Additionally, psychiatric levels remained stable in the group given Ambroxol, while they worsened in the group given the placebo. Furthermore, GFAP levels stayed stable in the Ambroxol group, while they increased in those who took the placebo. Participants on Ambroxol who had high-risk GBA1 gene variants showed improvements in their cognitive performance.
According to Dr. Pasternak, “Current therapies for Parkinson’s disease and dementia address symptoms but do not stop the underlying disease. These findings suggest Ambroxol may protect brain function, especially in those genetically at risk.” The cough syrup is used for treating respiratory conditions in Europe, and its safety has been proven over decades of use. However, it is not currently approved in either the United States or Canada.
Dr. Pasternak feels that research such as this is vital as Parkinson’s dementia affects patients and families profoundly. If it turns out that a drug with an existing safety record can help patients with Parkinson’s, it could significantly improve their quality of life. The clinical trial was funded by the Weston Family Foundation and published in JAMA Neurology. It is part of a growing effort to develop new treatments for cognitive disorders such as Parkinson’s, dementia, and Lewy bodies.
Based on Centuries-Old Medicine
Ambroxol is a synthetic version of vasicine, the key component of the Adhatoda vasica plant. In India, it is used as an ayurvedic medicine with a medicinal history spanning more than a thousand years. It was traditionally used for the treatment of asthma, coughing, phlegm, and hemorrhoids in both children and adults. The Adhatoda vasica plant has been found to contain antiseptic, antiarthritic, antimicrobial, abortifacient, and anti-inflammatory properties. It has been used in indigenous medicines to treat heart issues, leprosy, chronic bronchitis, fever, vomiting, and blood disorders.
The leaves would traditionally be boiled like a tea and used as an expectorant. In various parts of India, an extract is often used to stimulate uterine contractions, therefore speeding childbirth. It is quite surprising that a medicine that has been used traditionally in India for thousands of years, and for decades in Europe, still has not been approved for use in Canada and the United States.
The Bottom Line
Ambroxol has been safely used in Europe for respiratory relief for decades now. The findings of this latest clinical trial reveal that it could also potentially prevent dementia from developing in Parkinson’s patients. Considering that as many as 3 out of every four Parkinson’s patients eventually develop dementia, these findings could represent a real game-changer for the medical field. While the effectiveness and safety of a medicine always need to be considered, there are already many years of data to draw from. Even the ancient Indians regarded it as a powerful part of the ayurvedic medicinal arsenal. While further studies are still required, the future of Parkinson’s dementia treatment looks a little brighter every day.
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