Alzheimer disease (AD) remains one of the most dreaded diagnoses a patient can get. The US Food and Drug Administration (FDA) raised hopes when it approved aducanumab, which promised to be the first disease-modifying drug for AD. But the approval immediately proved controversial. Three FDA board members resigned
, the FDA then narrowed
its patient label, and in mid-July, major hospitals announced that they would not administer the drug
In this edition of Psych Pearls, Helen Lavretsky, MD, MS clarifies the issues in the aducanumab debate and offers guidance for clinicians whose patients may ask about it. Going beyond pharmacology, she points out that other treatment options, including mind-body interventions and diet changes, have been shown to slow AD’s progression.
In this conversation, Psychiatric Times and Lavretsky cover:
1. The aducanumab controversy
2. Advice for talking to patients and caregivers about aducanumab and other novel pharmacological options
3. Mind-body and lifestyle interventions for AD
4. AD prevention programs, including nutrition, exercise, and stress reduction
5. Taking care of caregivers, including psychiatrists and other medical professionals
6. How to prescribe joy
Dr Lavretsky is a professor in-residence in the Department of Psychiatry at the University of California, Los Angeles. Her work on geriatric depression and integrative mental health using mind-body interventions has received national attention, and she has won numerous grants supporting that work. A distinguished fellow of the American Psychiatric Association and a fellow of the American College of Neuropsychopharmacology, she is also on the board of Psychiatric Times.