More Memory Drugs and Nutrients Are on the Way

ecently, an FDA advisory panel decided that the age-related gradual slowdown in cognitive ability in normal individuals - those not previously considered to have neurodegenerative disease - is a valid category for clinical treatment. Called "mild cognitive impairment," or MCI (isn't this familiar?), this mental slowdown may not lead to more serious cognitive degeneration (only about 10-15% of those with it go on to Alzheimer's disease). Thus, treating MCI may fall into the preventive arena as well as that of enhancement, representing a significant change of tide for the FDA.

You better believe that drug companies have not missed the implications of this opening. In fact, many of them have been beating the drum for it all along, because its recognition could significantly expand the marketplace for memory-enhancement drugs. And that's good news for those of us for whom memory is so important.

Benefit for the Dietary Supplement Industry

From the dawn of modern neuroscience, the creation of memories has been viewed as the result of activity-driven alterations in the synapses of the brain.¹ Essentially, the mechanisms of the changes that determine how well we store information entail three phases: encoding, expression, and consolidation. Each of these phases has lent very clear ideas about the parts of the brain that represent likely drug targets. Now that the FDA has recognized MCI, the pull of economic success will hasten the drive of pharamaceutical companies to develop what must be called "smart drugs." Ostensibly, far fewer of us will become victims of the dreaded neurological diseases. But the "mild" boundaries are murky, and our hope is that the resulting products will take us beyond the maintenance of normal memory function to supranormal function, so that we may exceed what has previously been viewed as normal. Without a doubt, the benefit of added research in this area will influence research in the nondrug arena for cognitive enhancement.

Do not suppose that the FDA is on the side of smart drugs and for their widespread availability for all those who could benefit from them. To the contrary, the FDA is not about to give up control in this category, any more than it would in any other area of the pharmaceutical world it presides over. Yet as we enter the New Year, the idea of enhancement is upon us, so strongly that bureaucrats may not be able to hold back the tide, given the clamor for better health and the higher standards set by the nutritional supplement industry. As Victor Hugo wrote, "There is one thing stronger than all the armies in the world, and that is an idea whose time has come." Better memory is such an idea. And remember that memory extension is life extension. It can add life to our years, if not years to our life - and perhaps that too.

1. Lynch G. Memory enhancement: the search for mechanism-based drugs. Nat Neurosci 2002 Nov;5 Suppl 1:1035-8.