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Preliminary Findings of High-Dose Thiamine in Dementia of Alzheimer's Type

Department of Neurology, Medical College of Georgia, Augusta, GA.

David Loring, PhD

Department of Neurology, Medical College of Georgia, Augusta, GA.

Martha Nichols, MD

Department of Neurology, Medical College of Georgia, Augusta, GA.

Edward Zamrini, MD

Department of Neurology, Medical College of Georgia, Augusta, GA.

Michael Rivner, MD

Department of Neurology, Medical College of Georgia, Augusta, GA.

Hernan Posas, MD

Department of Neurology, Medical College of Georgia, Augusta, GA.

Elaine Thompson, BA

Department of Neurology, Medical College of Georgia, Augusta, GA.

Eugene Moore, BA

Department of Neurology, Medical College of Georgia, Augusta, GA.

Thiamine is important not only in the metabolism of acetylcholine but also in its release from the presynaptic neuron. Pathologic, clinical, and biochemical data suggest that thiamine deficiency is detrimental to the cholinergic system and that thiamine-dependent enzymes may be altered in Alzheimer's disease. Two previous studies reported contradictory results in patients with dementia of Alzheimer's type treated with 3 g/day of thiamine. In the present study, we examined the effects of 3 to 8 g/day thiamine administered orally. Our results suggest that thiamine at these pharmacologic dosages may have a mild beneficial effect in dementia of Alzheimer's type. The mechanism of the observed effect is unknown, but the findings warrant further investigation, not only for their therapeutic implications but for their possible etiologic clues. In addition, the results suggest long-term carry-over effects that should be considered in the design of future studies.

Journal of Geriatric Psychiatry and Neurology, Vol. 6, No. 4, 222-229 (1993)
DOI: 10.1177/089198879300600408


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