About half of all nursing home residents, an estimated 5 million people or so, have dementia. They have difficulty organizing their thoughts and managing their day-to-day activities. Often, they may not be able to read the newspaper or carry on a conversation. They may repeat themselves-or ask the person they are talking with to repeat what was just said. Doctors prescribe medications for Alzheimer disease, but such drugs have minimal impact on such dementia symptoms.
Can Medications Can Improve Dementia Symptoms?
Q. My 83-year-old mother was diagnosed with dementia several years ago. She has been declining in her mental capabilities and is on the Alzheimer’s drug Aricept.
She recently became ill with salmonella and was hospitalized for a week. There, she was prescribed Levaquin every other day for two weeks to clear the infection. After the third dose there was a remarkable improvement in her dementia symptoms. The days that she took the medication were better than the days she didn’t.
When she finished the medication, the dementia returned. I’ve asked her neurologist and medical doctor if there is a compound in Levaquin that could be responsible for the drastic improvement and they both said no. I know she can’t take this antibiotic on a long-term basis, but the results we saw were amazing.
Amazing Results from an Antibiotic:
A. We are intrigued by your report, even though we could find no evidence that antibiotics like levofloxacin (Levaquin) improve dementia symptoms. Such drugs can cause agitation and confusion. There is, however, one case report of a person with cognitive decline due to hydrocephalus becoming less apathetic and more capable during levofloxacin treatment (Neurologist, May, 2012).
Narcotics Offered Temporary Improvement:
Fifteen years ago, we received a number of reports about dementia symptoms being reduced or temporarily reversed by a narcotic such as hydrocodone or oxycodone. We can’t explain those unusual reactions any more than we can explain your mother’s temporary improvement. You can read some of those stories here. Perhaps some scientist will find your story interesting and conduct a study of antibiotics in people with dementia.
Could Lyme Disease Cause Dementia Symptoms?
As soon as this story was published, a doctor from San Antonio, TX, contacted us. Dr. AM reminded us that infection can sometimes cause dementia symptoms:
“The dementia of Alzheimer disease and the dementia of a spirochete infection is identical.
“In the New England Journal Of Medicine – Jan., 2013 – an 80-year-old female presented with dementia. Because of her past history of lymphoma, a lumbar puncture was performed looking for lymphoma cells. In the spinal fluid were spirochetes –Borrelia miyamotoi. The patient was treated with antibiotics resulting in a cure and the dementia disappeared.
“Borrelia burgdorferi infections (Lyme Disease) must be ruled out in all patients with dementia. Dr. Alan Mc Donald, pathologist, detected the DNA of the Lyme spirochete in 7 of 10 brains in Alzheimer patients.
This is referred to as neurospirochetosis. An infectious cause of dementia is treatable and curable.”
Borrelia miyamotoi can infect the central nervous system (Emerging Infectious Diseases, Sep., 2016). The usual treatment for this pathogen is doxycycline or amoxicillin, however, rather than a drug like levofloxacin (Clinics in Laboratory Medicine, Dec., 2015). As a result, we don’t know if this fascinating hypothesis might actually help explain your mother’s temporary improvement.
We have two interviews that may be of interest to those who want further information. In one, Dale Bredesen, MD, describes his multifactorial approach to treating dementia. In the other, Edward Breitschwerdt, DVM, and Robert Mozayeni, MD, discuss the many different sorts of pathogens that can be transmitted by ticks or fleas. The specific infection they focus on most, Bartonella, can cause severe cognitive symptoms.
The Trouble with Levaquin:
Even if this were the explanation-and we don’t know that it is-we could not recommend levofloxacin for people with dementia. Fluoroquinolone antibiotics like ciprofloxacin (Cipro), levofloxacin (Levaquin) and moxifloxacin (Avelox) have some serious side effects and should be reserved for situations where they are the only appropriate antibiotic. (That would not include most tick-borne infections, which are usually treated with doxycycline, amoxicillin or cefuroxime).
Side effects of fluoroquinolones include:
- agitation
- confusion
- anxiety
- muscle and/or joint pain
- tendinitis or tendon rupture
- insomnia
- tremors, restlessness
- headache
- digestive distress
- dizziness
- severe skin reactions, sun sensitivity
- peripheral neuropathy
- uveitis
- seizures
- diarrhea due to C. difficile overgrowth
- depression
- heart rhythm disturbance
- toxic psychosis, hallucinations, paranoia
- suicidal thoughts or actions
Older people appear to be especially susceptible to these side effects, particularly the serious ones.
