Currently it is not clear which drugs are useful for the treatment of people with symptomatic CJD or after a few months following their inoculation with disease.
It is important to state that all doctors can prescribe drugs that they feel is of value to a patient of theirs. This drug may well be not licensed by a government body. However it is necessary for a doctor to do this to be able to say: 'I, as the patient's doctor, feel and have good reason to feel, that the drug will do my patient potential good and that this will be considered greater than any harm'.
The problems with this are clear in that many doctors do not know enough about CJD, or about the obscure drugs that are considered for CJD. Also, he may well not be able to state that the risk must be thought of as being low as a result of the drug in that some of them are not available in a pharmaceutical form. As a result it is unlikely for a patient to find a doctor that will prescribe the drugs that are not specialised in the field of CJD and possibly in the treatment aspects of it.
As a result of this, currently only 7 drugs could be even considered:
- Quinacrine (no evidence of its action in vivo)
- Amphotericin B (poor effect unless given early in the incubation period)
- Pentosan polysulphate (possibly only orally) (only as prophylaxis) (now possibly as treatment when given directly into the brain)
- Dapsone (no adequate evidence of action)
- Flupirtine (no published data on human action)
- Tetracycline (no adequate information)
- Anti-PrP (a prophylactic agent in mice experiments: no effect in symptomatic patients expected)
- Anti-oxidants (no evidence of activity in CJD: but good in Alzheimer's)
- Imatinib (Glivec) (no evidence of activity in clinical CJD and mode of action is not easily explained)
Some of the drugs that are not considered currently may actually be developing into useful ones.
For instance the iododoxorubicin analogues that are being produced, the analogues of amphotericin B and the altered forms of pentosan that may penetrate the central nervous system.
In fact the drug companies feel that they may make their money not from CJD but really from Alzheimer's disease in that similar drugs may act on that.