Antibiotic Minocycline shows potential as stroke treatment

People treated with the drug minocycline within six to 24 hours after a stroke had significantly fewer disabilities, according to a study published in the October 2, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.

Researchers say minocycline may be an alternative treatment for stroke because current treatments only work during the first few hours after the onset of symptoms, and many people don't get to the hospital in time to be treated. Minocycline is normally used to treat bacterial infections including pneumonia and other respiratory tract infections; acne; and infections of skin, genital, and urinary systems.

For the study, 152 men and women received either an oral dose of minocycline or placebo for five days following stroke. People who received minocycline were treated an average of 13 hours after stroke compared to 12 hours for the placebo group. Researchers followed both groups for three months.

The study found people treated with minocycline had significantly better outcomes than those treated with placebo. After three months, the minocycline group performed four times better than the placebo group on the National Institutes of Health Stroke Scale, which measures vision, facial palsy, movement, and speaking ability. The minocycline group received a score of 1.6, which indicates little or no disability, compared to a score of 6.5 for the placebo group, which indicates a high end of mild disability.

“The improvement was already apparent within a week of the stroke,” said study author Yair Lampl, MD, with Edith Wolfson Medical Center and Tel Aviv University in Israel. “This is exciting because many people who have had stroke cannot be treated if they don't get to the hospital within three hours after symptoms start, which is the time frame for current available treatments.”

“While these are promising results, a much larger, closed-label, study is needed to confirm our findings,” said Lampl. “Further research is also needed to look at whether the dosage of the drug taken in this study is optimal and whether giving the drug through an IV would be more effective.”

Lampl says the improvement shown by patients taking minocycline is not due to the drug's basic antibiotic effect, but rather its anti-inflammatory effect and ability to protect brain cells from destruction. Minocycline has already been shown in other studies to have a neuroprotective effect in animal models of multiple sclerosis, Parkinson's disease, Huntington's disease, and Lou Gehrig's disease, or ALS.

Lampl says none of the participants experienced any serious side effects from the drug.

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