Davangere Devanand, MBBS, MD: Lithium for Agitation in Alzheimer Disease

"It's been very difficult to treat symptoms of agitation and aggression in Alzheimer disease."

Davangere P. Devanand, MBBS, MD, a professor of psychiatry in neurology at the Gertrude H. Sergievsky Center at Columbia University Medical Center sat with NeurologyLive at the Alzheimer’s Association International Conference held in Chicago, Illinois, to talk about the difficulty in treating symptoms of agitation in Alzheimer disease, and the possibility of using lithium for it.

Devanand spoke about a trial he’s helping to conduct, funded by the National Institute on Aging, that is testing lithium, an affordable and generic option, in 80 patients with Alzheimer disease and symptoms of agitation. Currently, the available treatments consist mostly of antipsychotics, which can cause toxicity and have an FDA black box warning due to mortality risk. Lithium, which is the gold standard in treating bipolar disorder, is hypothesized to be able to address symptomatic fluctuations in patients with Alzheimer in low doses.

The trial, Devanand said, is a phase II, randomized, placebo-controlled, blinded trial and is going to utilize doses of 150 mg to 600 mg of daily lithium in patients, with a target blood level of 0.2 to 0.5. Thus far, 50 patients have been enrolled. If successful, the group of investigators will seek to confirm the results in a larger, phase III trial, he added.