"Genius Pill" May Relieve Chemobrain

(WebMD)  A so-called "genius pill" may enhance memory and attention among breast cancer survivors who suffer from the condition known as "chemobrain," a small study suggests.

The researchers looked at the effects of Provigil, a drug used to treat excessive sleepiness from certain sleep disorders, in 68 women suffering from chemobrain, also referred to as chemo fog. Chemobrain is mild cognitive impairment characterized by the inability to remember certain things, complete certain tasks, or learn new skills.

"After just four weeks of treatment, we saw improvements in their ability to recall," says researcher Sadhna Kohli, PhD, MPH, a research assistant professor at the University of Rochester's James P. Wilmot Cancer Center. "Those who continued taking the drug for eight weeks saw improvements in attention," she tells WebMD.

Kohli stresses that the results have to be replicated in more women and for longer periods of time before Provigil should be prescribed for chemo brain, however.

The findings were presented here at the American Society of Clinical Oncology's annual meeting.

For years, many doctors doubted the existence of chemobrain, although many people with cancer complained of problems with memory, concentration, and attention skills during and even after treatment with chemotherapy drugs.

But "it's increasingly being acknowledged as a real phenomenon for some patients," says Ann H. Partridge, M.D., PhD, a cancer doctor at Dana-Farber Cancer Institute in Boston. She was not involved in the study.

In a separate study last year, Kohli and colleagues found that 82 percent of 595 people with cancer given chemotherapy reported problems with memory and concentration.

"Some of them say it would resolve very quickly after treatment ended; some say it lingers for years," Kohli says.

Since people with chemobrain find it very hard to pay attention, the deficits can lead to job loss and social problems, she says.

The new analysis looked at whether Provigil, designed to promote wakefulness among those with sleep disorders including narcolepsy, would help relieve symptoms and improve mental function.

Provigil seems to boost brainpower without causing the jittery, restless feelings induced by amphetamines, Kohli explains. It stimulates the brain only when it is required, with effects dissipating in about 12 hours. As a result, sleep-deprived college students, athletes, soldiers, or others who want to gain an edge in a competitive environment sometimes seek out the drug, calling it a genius pill.

In the study, 68 women who had completed chemotherapy treatment for breast cancer were given the drug for four weeks. Then, for another four weeks, half of the women continued to receive the drug while the others were given a placebo pill.

The women were given a series of cognitive tests before starting the drug, at four weeks and at eight weeks. For example, they would be asked to watch a series of pictures or words flashed on a screen and then asked to recall them five minutes later. Results showed that after just four weeks, women could recall faster and more accurately recognize words and pictures. By eight weeks, attention deficits improved and memory was even better.

Since Provigil does not linger in the body, side effects are minimal, according to Kohli.

"This is a very provocative and exciting study," Partridge tells WebMD. "Chemo fog can hamper some people's lives for a long time, if not forever. I hope to see confirmatory findings soon."

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By Charlene Laino
Reviewed by Louise Chang, M.D.
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