Treatment of cerebellar ataxia with 5-HT1A agonist.

Abstract

Effective, pharmacologic approaches to the treatment of cerebellar ataxia are lacking or inadequate. We recently reported preliminary evidence that tandospirone citrate (tandospirone), a 5-HT1A agonist, improved cerebellar ataxia in patients with Machado-Joseph disease (MJD). In the course of that study, we found that such treatment also alleviated the pain associated with cold sensations in the legs, insomnia, anorexia, and depression, all of which are thought to be mediated through activation of the 5-HT1A receptor. In this paper, we reviewed the few published clinical trials that involved the use of 5-HT1A receptor agonists for the treatment of cerebellar ataxia, and discussed the current theories regarding their mechanism of action. Cortical cerebellar atrophy (CCA) was reported, in a double-blind study, to be amenable to treatment with tandospirone. Other types of spinocerebellar degeneration (SCD) i.e., olivopontocerebellar atrophy (OPCA) and Machado-Joseph disease (MJD) have also been reported to respond to the drug, but these have been small studies. Responsive patients exhibited only mild ataxia. The doses of 5-HT1A agonists that have been used successfully ranged from 12.5 mg/day to 60 mg/day (or 1 mg/kg), and were well tolerated by most patients.

• Authors: Asako Takei, Takeshi Hamada, Ichiro Yabe, Hidenao Sasaki
• Journal: Cerebellum (London, England) (Cerebellum) Vol. 4 Issue 3 Pg. 211-5 ( 2005) ISSN: 1473-4222 [Print] United States
• PMID: 16147954 (Publication Type: Journal Article, Review)

Chemical References

• Serotonin 5-HT1 Receptor Agonists
• Serotonin Receptor Agonists
• Buspirone

Topics

• Buspirone (therapeutic use)
• Cerebellar Ataxia (classification, drug therapy)
• Clinical Trials as Topic
• Humans
• Serotonin 5-HT1 Receptor Agonists
• Serotonin Receptor Agonists (therapeutic use)