When I learned of the Food and Drug Administration’s approval of aducanumab (Aduhelm) for Alzheimer’s disease, I was struck by the parallels with the agency’s approval of tacrine (Cognex) in 1993, the first drug approved for Alzheimer’s which was later removed from the market.
As a young scientist at the National Institutes of Health studying Alzheimer’s disease in the late 1980s, I — and many of my colleagues — focused on a substance called acetylcholine. It is a neurotransmitter that is important for attention and memory. Scientists had found that a large hub of nerve cells that make acetylcholine showed severe damage in people with Alzheimer’s disease. The hope was that increasing acetylcholine in the brain could ease Alzheimer’s symptoms, at least for some time, much as dopamine replacement helps people with Parkinson’s disease.