Existing drugs point to first treatment for strokes linked to dementia (Isosorbide mononitrate and cilostazol)

Medical Xpress / University of Edinburgh / JAMA ^ | May 24, 2023 | Joanna M. Wardlaw, MD et al

[ConservativeMind]

People who experience a type of stroke linked with nearly half of all dementias could be treated for the first time by repurposing two cheap and common drugs, a trial shows.

Researchers found that isosorbide mononitrate and cilostazol, which are already used to treat other heart and circulatory diseases, can safely improve the debilitating outcomes people experience after lacunar stroke.

The two drugs, which were found to be even more effective when used in combination.

Lacunar strokes affect at least 35,000 people in the UK each year. They are caused by cerebral small vessel disease, where small blood vessels deep within the brain become damaged and stop working properly.

There are currently no specific effective treatments.

The trial involved 363 people who had experienced a lacunar stroke.

As well as their standard stroke prevention treatment, for one year participants took either isosorbide mononitrate or cilostazol individually, both drugs together, or neither.

Participants that took both drugs were nearly 20 percent less likely to have problems with their thinking and memory compared to the group that did not take either drug. They were also more independent and reported a better quality of life.

In addition, those who took isosorbide mononitrate were less likely to have had further strokes at one year than those who did not take the drug.

Taken on their own, isosorbide mononitrate also improved thinking and memory skills, and quality of life, while cilostazol improved independence and mood. These effects were strengthened when the two drugs were taken together, researchers say.

Professor Joanna Wardlaw said, "We need to confirm these results. However, as these drugs are already widely available for other circulatory disorders, and inexpensive, it shouldn't take too long to move our findings from research into everyday clinical practice."

[ConservativeMind]

These two drugs are currently available and are inexpensive.

Talk to your doctor about them.

[ConservativeMind]

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[jagusafr]

I took isosorbide mononitrate for nearly 4 years after I had stents placed. When I read that it was for chest pain and I didn’t have any, I stopped taking it. No issues. I’m also off of my blood pressure medications because of “food as medicine“. The fewer pills, the better, as far as I’m concerned. Diet will often trump medicine.