Idebenone is a benzoquinone compound which has been investigated in elderly patients with dementia. Its precise mechanism(s) of action remains unknown, but in vitro and in vivo studies suggest the drug may diminish nerve cell damage due to ischaemia, correct neurotransmitter defects and/or cerebral metabolism and facilitate memory and learning.
In the small number of studies available for evaluation, idebenone was generally superior to placebo and comparable with bifemelane, oxiracetam and nebracetam on the basis of a number of objective and subjective tests and rating scales in patients with mild to moderate cognitive decline. Clinical trial results indicate that patients with mild dementia seem more likely to respond than those with greater functional decline. The degree of benefit conferred by idebenone is often difficult to determine, but in those who respond, improvement is generally mild to moderate. Therapy with idebenone appears well tolerated for up to 2 years, and no changes in vital signs or laboratory values have been seen in clinical trials. In view of the lack of a proven agent to limit or halt the progression of dementia in the elderly, idebenone may warrant consideration in patients with mild cognitive dysfunction on the basis of preliminary evidence of predominantly mild improvement of functional status in some patients and good tolerability. However, further well designed studies, including comparisons with newer and commonly used agents, such as tacrine, are required to better define the role of idebenone in this complex area of treatment.
Idebenone is a powerful antioxidant and positively affects brain chemistry. Idebenone has been shown to promote information transfer across the corpus callosum, the membrane separating the right and left brain hemispheres. Idebenone has been used to treat Alzheimer's and to lessen damage from strokes. Idebenone can increase production of the brain neurotransmitters serotonin, dopamine, adrenalin, and noradrenanlin. Idebenone is a potent cerebral stimulant that can dramatically increase brain energy. Like Coenzyme Q10, Idebenone has protection qualities for the heart and is seen as a potent antioxidant. But Idebenone also enhances brain levels of serotonin, norepinephrine, and increases brain levels of nerve growth factor; effects that have not been demonstrated with CoQ10. Idebenone also protects the brain's myelin sheath and prevents damage to mitochondria. Idebenone has no known side effects. Idebenone is regarded as an important anti-aging supplement.
In most respects, Idebenone shares its traits with Coenzyme Q10. Like Coenzyme Q10 is might be useful for aging. It differs from it in some important ways, which may make it more useful. Under certain circumstances, Coenzyme Q10 (CoQ10) may become a pro-oxidant. These circumstances are conditions in which hypoxia or lack of oxygen occurs. In cases of shock, heart attack, stroke, or poor circulation, CoQ10 auto-oxidizes and unleashes massive amounts of various free radicals that damage delicate tissues and because CoQ10 is necessary for electron transport and ATP (chemical energy) production, cellular death may ensue. Idebenone, on the other hand, suppresses free radicals and continues ATP production in hypoxic situations. This may make it a useful supplement for individuals at risk for those conditions.
Other important traits of Idebenone not shared by CoQ10 include the ability to raise the brain's serotonin levels like the SSRI antidepressants (Prozac) and it also increases the brain levels of nerve growth factor. Another trait is to protect the myelin sheath from damage as well as the mitochondria that has important implications in Multiple Sclerosis.
The ability to enhance serotonin production occurs even under less than optimal conditions such as those whose diet contains little L-Tryptophan.