A medical food is now available for management of mild-to-moderate dementia with the launch last month of Axona (Accera). The once-daily prescription product, described by the manufacturer as providing alternative energy to the brain, is formulated to improve brain metabolism and associated energy imbalances in patients with AD.

According to Jeffrey L. Cummings, MD, Director of the Mary S. Easton Center for Alzheimer's Disease Research at UCLA and a consultant for Accera, the theory behind development of Axona moves beyond the role of amyloid in AD. "The amyloid hypothesis is alive and well although subject to constant refinement," Dr. Cummings observes. "This does not preclude developing therapies addressing other types of disturbances in AD including hypometabolism. The Axona approach may well stimulate further investigation into medical foods or other dietary approaches."

In a double-blind, randomized study involving patients with probable mild-to-moderate AD, those taking Axona had significant improvements in ADAS-Cog scores by day 45. Treated patients maintained slight improvement from baseline at day 90 versus controls, who declined.

The powder formulation is provided in individual packets to be dissolved in water and taken with breakfast. In trials, Axona was found to be safe and well-tolerated.

In addition to offering cognitive benefit, Axona may point to new directions in AD research and therapy. "The data regarding Axona are evolving," Dr. Cummings says. "They raise interesting questions and point in new directions." However, he notes there is still much to learn. "We need to know more before we would say that the Axona data are reforming the way we look at the disease," he adds.

New Mexico Rolls Out Medical Marijuana Initiative
President Barack Obama didn't endorse legalization of marijuana for personal use as a way to stimulate the economy, but the New Mexico Department of Health has approved the first nonprofit in the state to produce medical marijuana for patients in the department's Medical Cannabis Program.

The Health Secretary will consider the health needs of "patients and the public safety" in determining the number and location of licenses the department approves. Patients in the Medical Cannabis Program can also apply to produce up to four mature plants and 12 seedlings for personal use. So far, 23 patients have been approved to be their own producers. Nonprofits are allowed to produce up to 95 mature plants and seedlings and maintain a usable inventory.

The department will not release the name or location of the producer citing safety concerns and will notify certified patients how to contact the licensed producer. Under current state law, several neurologic conditions qualify for the medical marijuana program (Table). Patients in hospice care could also qualify.

The health board announced it would be willing to reconsider petitions for chronic pain, bipolar disorder, arthritis, and others. If a patient does not have a qualifying condition and their physicians feels they would benefit from marijuana, that person can petition the Medical Advisory Board to add their condition to the current list.

The bill was hotly contested. "Medically it just really has no value," argued Rep. John Heaton, a pharmacist, to the Santa Fe New Mexican. "For us to approve a drug like this tells our children and tells the rest of the people in this state that we, somehow as leaders, give tacit approval to the use of this drug."

Proponents of the bill point to prescription drug abuse figures to counter criticism about marijuana's societal effect. About 2.1 million people abused or became dependent on psychotherapeutics used non-medically in 2007, according to Substance Abuse and Mental Health Services Administration. In 2008, seven of the top 10 drugs abused by teenagers were prescribed or purchased over the counter, according to the National Institute on Drug Abuse.

Illinois is weighing a similar bill, according to the Southtown Star.