Reversing and treating mild cognitive impairment (MCI) with medication are often prescribed for a brain chemical deficiency in conjunction with other therapies or when other treatments are not effective. (see post “Natural Hormone Therapy For Mild Cognitive Impairment” and “A 7- Step Action Plan For Preventing And Treating Memory Loss“). These medications work in several different ways to bring brain chemicals into balance or even enhanced. One mechanism is – the medication imitate (is an analog) of a particular brain chemical, triggering the brain to respond as if it is the brain chemical itself. The other mechanism is – the medications block (bind to) the nonspecific receptors so that the brain chemical itself will not bind to the nonspecific receptors, thereby increasing the availability of the brain chemical for brain functional use. (see post “brain chemical systems and memory“)
The medications that increase dopamine can help regain or enhance attention. The medications that stimulate acetylcholine production can improve memory. The GABA medications relieve anxiety. The serotonin medications treat depression and insomnia both of which adversely affect thinking. Without anxiety and depression, MCI can more easily reversed and the memory issues resolve themselves. At the same time, physical symptoms of many other diseases also resolve once the brain chemical is rebalanced, thus improving the overall physical and mental health.
GABA medications lessen anxiety. Anticonvulsants are a group of GABA medications that are typically used to prevent or treat convulsions or seizures. In low doses, they are also effective to treat mood. How anticonvulsants work to improve mood is not known. Another type of GABA medication is benzodiazepines which are tranquilizers. Some of the benzodiazepines are used to relieve anxiety while others are used to treat insomnia.
Serotonin enhancing medications include antidepressants. Antidepressants are the most common type of serotonin-enhancing medications which can stimulate neurogenesis. Antidepressants also increases the number of receptors for brain chemicals therefore increasing the response to neurotransmitters. Antidepressants are known to improve brain speed. Although all antidepressants increases serotonin, they do not work the same way:
- monoamine oxidase (MAO) inhibitors act on (inhibit) mitochondrial enzymes that degrade both dopamine and serotonin. MAO inhibitors cause more serotonin to be available in the synapses. Because of the adverse side effect and the improved efficacy of other antidepressants, MOA inhibitors are not widely prescribed.
- tricyclics block the reuptake of dopamine and serotonin, causing an increase in the level of these brain chemicals in the synapses. Because of the adverse side effect and the improved efficacy of other antidepressants, tricyclics are not widely prescribed either.
- selective serotonin reuptake inhibitors (SSRIs) can quickly increase the serotonin in the brain, resolving depression. Examples of SSRIs include: citalopram, Escitalopram, Fluoxetine, Paroxetine, Sertraline.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) are known as dual reuptake inhibitors that can increase both serotonin and norepinephrine. SNRIs can improve mood and attention. Examples are: Duloxetine, Milnacipran, Venlafaxine.
- Bupropion (Wellbutrin) can block the reuptake of dopamine, not serotonin, but it is an effective antidepressant. This medication was found to improve cognition.
- Buspirone (BuSpar) affect dopamine and serotonin and is used to treat mild sleep disorders and mild anxiety.
Some blood pressure medication can stop MCI or memory loss such as atenolol because they improve blood flow to the brain.
Acetylcholine medications boost the strength of existing brain signals and can reverse symptoms of MCI, although they do not cure MCI. The improvement may last only as long as the medication is in the body. Examples of acetylcholine-enhancing medications are: Donepezil, Galantamine, Rivastigmine, Tacrine.
Dopamine medications help increase attention which are relatively very successful. Examples are: Atomoxetine HCl, Bupropion, Dexmethyphenidate, Dextroamphetamine, Dextroamphetamine + amphetamine, Guanfacine, Lisdexamfetamine dimesylate, Methamphetamine, Methylphenidate.
Leptin-enhancing medications is for managing leptin levels, although leptin can self-regulate once the brain chemicals are balanced. Leptin-enhancing medications are also prescribed for many other health concerns. Examples are: leptin analog (for weight management), Bupropion (for depression and attention), Topiramate (for seizures, anxiety) and many others.
Reference: book by Eric R. Braverman, MD.