A Pilot of Methylphenidate in Mild Cognitive Impairment and Dementia Participants.
Alzheimer Dementia
About this trial
This is an interventional supportive care trial for Alzheimer Dementia
Eligibility Criteria
Inclusion Criteria:
Study subjects meeting all of the following criteria will be allowed to enroll in the study:
- Aged 55-95 inclusive;
- Diagnosis of MCI or mild-stage dementia presumed due to AD and AD-related disorders;
- Cognitive abilities sufficient to be able to complete all study tasks as determined by the PI or a Co-I;
- Education level, English language skills, and literacy that indicates participant will be able to comprehend all assessments;
- Neuropsychiatric Inventory Agitation/Aggression Question 4 = "No" or "Yes" with a mild severity rating.
- Willing and able to complete all assessments and study procedures;
- Not pregnant, lactating, or of child-bearing potential
- Volunteer has a Study Partner with at least two days per week of contact and willing to complete partner study forms;
- No exclusionary medications or dietary supplements. See Section 6.5.8.1
- If on cholinesterase inhibitor and/or memantine, doses are stable for 3 months prior to baseline.
- Basic video conferencing capabilities and a willingness to participate in a virtual trial (including self-administration of ECG).
Exclusion Criteria:
Subjects meeting any of the following criteria during the screening evaluation will be excluded:
- Any history of specific CNS disease other than AD or AD-related disorders, such as major clinical stroke, brain tumor, normal pressure hydrocephalus, multiple sclerosis, significant head trauma with persistent neurological or cognitive deficits or complaints;
- Clinically significant or unstable medical condition that could affect safety or compliance with the study and would, in the opinion of the investigator, pose a risk to the participant if they were to participate in the study;
- Major active or chronic psychiatric illness (e.g. depression, bipolar disorder, obsessive compulsive disorder, schizophrenia) within the previous year;
- Current suicidal ideation or history of suicide attempt;
- History of alcohol or other substance abuse or dependence with the past two years;
- Clinically significant abnormalities on complete blood count, comprehensive metabolic panel, B12, or TSH screening safety lab results;
- Concomitant use of medications with psychoactive properties that may deleteriously affect cognition (anticholinergics, antihistamines, antipsychotics, sedative hypnotics, anxiolytics);
- Treatment with monoamine oxidase inhibitors, coumadin, phenobarbital, phenytoin, primidone, tricyclic antidepressants or other medicines with potential for clinically significant interaction;
- Hypersensitivity to MPH;
- History of marked anxiety and agitation, ADHD, motor tics, glaucoma, or a history or family history of Tourette's Syndrome;
- Clinically significant cardiac condition for which MPH may be contradicted as determined by study physician, such as MI or ventricular arrhythmia within 6 months of enrollment;
- History of untreated, uncontrolled hypertension or a blood pressure greater than 150/90 during the screening period;
- Use of other small molecule or device- based investigational agents one month prior to entry and for the duration of the trial.
Sites / Locations
- Massachusetts General Hospital, Clinical Translational Research Unit
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Sequence 1:MPH, PBO, MPH, PBO, PBO, MPH
Sequence 2:MPH, PBO, PBO, MPH, MPH, PBO
Sequence 3:MPH, PBO, PBO, MPH, PBO, MPH
Sequence 4:PBO, MPH, MPH, PBO, MPH, PBO
Sequence 5: PBO, MPH, MPH, PBO, PBO, MPH
Sequence 6: PBO, MPH, PBO, MPH, MPH, PBO
Over the 16-week study, each participant moved through four, 4-week treatment periods: a Placebo (PBO) lead-in, acclimation period followed by three, crossover Methylphenidate (MPH) vs PBO "blocks". Each "block" consisted of treatment with MPH for two-weeks and treatment with PBO for two-weeks; each block order will be randomly assigned. In this group, participants first received Methylphenidate (MPH) for 2 weeks, then placebo for 2 weeks, then MPH for 2 weeks, then Placebo for 2 weeks, then Placebo for 2 weeks, then MPH for 2 weeks.
Over the 16-week study, each participant moved through four, 4-week treatment periods: a Placebo (PBO) lead-in, acclimation period followed by three, crossover Methylphenidate (MPH) vs PBO "blocks". Each "block" consisted of treatment with MPH for two-weeks and treatment with PBO for two-weeks; each block order will be randomly assigned. In this group, participants first received Methylphenidate (MPH) for 2 weeks, then placebo for 2 weeks, then PBO for 2 weeks, then MPH for 2 weeks, then MPH for 2 weeks, then PBO for 2 weeks.
Over the 16-week study, each participant moved through four, 4-week treatment periods: a Placebo (PBO) lead-in, acclimation period followed by three, crossover Methylphenidate (MPH) vs PBO "blocks". Each "block" consisted of treatment with MPH for two-weeks and treatment with PBO for two-weeks; each block order will be randomly assigned. In this group, participants first received Methylphenidate (MPH) for 2 weeks, then placebo for 2 weeks, then MPH for 2 weeks, then Placebo for 2 weeks, then Placebo for 2 weeks, then MPH for 2 weeks.
Over the 16-week study, each participant moved through four, 4-week treatment periods: a Placebo (PBO) lead-in, acclimation period followed by three, crossover Methylphenidate (MPH) vs PBO "blocks". Each "block" consisted of treatment with MPH for two-weeks and treatment with PBO for two-weeks; each block order will be randomly assigned. In this group, participants first received PBO for 2 weeks, then MPH for 2 weeks, then MPH for 2 weeks, then Placebo for 2 weeks, then MPH for 2 weeks, then PBO for 2 weeks.
Over the 16-week study, each participant moved through four, 4-week treatment periods: a Placebo (PBO) lead-in, acclimation period followed by three, crossover Methylphenidate (MPH) vs PBO "blocks". Each "block" consisted of treatment with MPH for two-weeks and treatment with PBO for two-weeks; each block order will be randomly assigned. In this group, participants first received PBO for 2 weeks, then MPH for 2 weeks, then MPH for 2 weeks, then Placebo for 2 weeks, then Placebo for 2 weeks, then MPH for 2 weeks.
Over the 16-week study, each participant moved through four, 4-week treatment periods: a Placebo (PBO) lead-in, acclimation period followed by three, crossover Methylphenidate (MPH) vs PBO "blocks". Each "block" consisted of treatment with MPH for two-weeks and treatment with PBO for two-weeks; each block order will be randomly assigned. In this group, participants first received PBO for 2 weeks, then MPH for 2 weeks, then PBO for 2 weeks, then MPH for 2 weeks, then MPH for 2 weeks, then PBO for 2 weeks.