Ambroxol for PD

I suppose it is selfish of me to think that this is bad news DHP?

At the moment this research finding appears to be well under the radar, when a peer review appears confirming it (or not), then it will likely have an impact. From what I read, the COVID vaccines(s) will likely not be 100% effective (have seen 70% maybe), plus their mass availability is still many months off, not to mention many people do not plan to take them, and then of course there are COVID mutations occuring which may reduce their effectiveness further, and the possibility of some side effects that did not appear in the latest human trials. All that is to say that if in fact Ambroxol is to an extent a prophylactic for COVID as the initial research suggests, then at some point that will have an impact on its availability, how could it not. But we’ll see. Given how much Ambroxol I take daily, I may be pretty inhibited against the agent that causes coronavirus, and at my age that’s a good thing, in addition to its PD benefits which started me taking it in the first place, at least for me.

new publication:

“Ambroxol has a proven antiviral effect and a unique stimulatory action on the secretion of surfactant by alveolar type II cells, the main target of SARS-CoV-2. Surfactant may form a fundamental defence mechanism against the virus.”

https://www.sciencedirect.com/science/article/pii/S0924857920303988

Wow!
It would seem that ambroxol is multi-talented, as you’ve said before.
If it can indeed help to protect against COVID-19 that’s a huge added bonus.

yes, that Adhatoda Vasica plant from which Ambroxol was derived certainly suggests it has a number of applications beyond PD. The leaves, roots and flowers of Adhatoda have been used extensively in traditional Indian medicine for hundreds if not thousands of years.

Yet another new finding of repositioned Ambroxol as having anti-SARS-CoV2 promise:

CONCLUSIONS
…we show evidence that AQ…and ambroxol are promising repositioning candidates, with independently confirmed in vitro anti-SARS-CoV-2 activity.

What to me is most interesting about their conclusion, is that the scientists are not clear on how Ambroxol does it (so they ‘speculate’), and note that it may have ‘broad applicability’ on other human diseases (which of course we know):

THE AMBIGUITY OF AMBROXOL
… ambroxol’s beneficial effect is not related to direct antiviral activity Both bromhexine and ambroxol induce autophagy in vitro . Although the different cell systems in which these drugs were tested might influence the experimental results, ambroxol was measured to be at least twice as potent as bromhexine at clinically relevant concentrations. Moreover, ambroxol has been shown to induce autophagy in mice lung cells. Drugs that modulate autophagy could have a broad applicability on several human diseases, including the treatment of viral infections. However, autophagy modulation, as an alternative mechanism of action for COVID-19, has not been elucidated yet. Nevertheless, it should be noted that such modulation is induced by drugs (bromhexine and ambroxol) that have similar pharmacophoric features to chloroquine and HCQ, yet their antiviral mechanism could be different. To clarify the situation, confirmatory CPE experiments for both ambroxol and bromhexine are required, with ambroxol needing higher in vitro test concentrations to fully explore its effects in the Vero E6 assay. Since ambroxol (at 50 μM) is inactive in the titer reduction assay ( vide infra ), we speculate that the use of ambroxol or bromhexine in SARS-CoV-2 infected patients may be beneficial via another (not directly antiviral) mechanism.

https://pubs.acs.org/doi/10.1021/acsptsci.0c00131

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More on Ambroxol & COVID on LinkedIn below recently suggesting all should have some on hand. As for me, I continue to take mostly what the researchers call a low dose (600mg a day) of Ambroxol for my PD. At 10 months I can report my brain fog is still completely at bay, and I continue on a lower dose of Levadopa and Amantadine to control my other symptoms at 4 years since diagnosis (been off Requip for about 4 months, side effects ultimately were very bad for me). My neurologist thinks I am holding pretty steady - I’ll take that slowing any day.

“Bromhexine (which the body metabolizes to ambroxol) has been shown highly effective against COVID”.

https://www.linkedin.com/pulse/what-you-can-do-someone-know-gets-covid-19-infection-leibrand/

Hi DHP, hope you are well, how are you getting on with Ambroxol for your PD?

Dave.

thanks for asking Dave! Its been almost a year since I started taking Ambroxol, and my mental clarity remains excellent with no creep back of PD brain fog, which is huge for me (particularly given the longer term PD dementia risk). Most of that time I have been on 600mg a day (a low dose in the current trial underway), but I have tried 900mg for some periods, and still want to try 1,200mg (high dose) when I have the supply for it (trial results later next year should tell us something about the optimal dose requirement). As far as mobility issues, they have not worsened over that period (which my neurologist confirms), which suggests to me it does slow PD progression. I have experienced some motor improvements, like in my typing, facial gestures and much reduced freeze events, but I still am hoping for more significant improvements as time goes on. Just as it took years for me to develop PD, I have to believe it will take time for Ambroxol PD reversal benefits to be fully experienced. In fact recently I have begun to wonder if its long term use isn’t starting to payoff for me. We’ll see. What I can say is that it has enabled me to stay on a very low dose of Levedopa daily (1/2 of the low dose I have been prescribed). with no Ropinirole (Requip) needed for motor improvement and freeze reduction. To me that is also huge, as I don’t want to become more dependant on Levadopa, and Ropinirole side effects were very, very bad for me. Quite honestly, I truly believe that were it not for Ambroxol, my life would be going down a much darker road, and instead I have chance to hold on (or more) until something perhaps even better comes along (if it even needs to). One thing I will say is that I started taking Ambroxol fairly early after my PD diagnosis (within a few years), and it may be important when you start just how much it can do for you longer term, but I do think is can really help mental clarity no matter when you start it based on my experience and other anecdotal feedback. Thank again for asking, and hope you are doing well also!

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Hi DHP,
I am not too bad thank you. Thanks for your detailed reply. I am very interested in Ambroxol, at least as an add-on. It is a shame there has been no phase 3 trial yet because until there is it will not be generally prescribed. So yet again patients are left to self experiment.
Where have you been sourcing your Ambroxol from? I notice there are quite a few places when I Google.
Regards,
Dave.

glad your’e doing ok. With regard to Ambroxol source, best to just search on it, can’t say more without breaking forum rules.

given my cognitive benefits continue, very positive on the results of the Ambroxol for PD dementia trial ending this year with findings to be published in 2022:

https://www.centerwatch.com/clinical-trials/listings/168579/parkinsons-disease-dementia-ambroxol-as-treatment-parkinsons/

beyond that, it appears there is a similarly focused Norwegian trial in the planning stages as well:
https://alz-journals.onlinelibrary.wiley.com/doi/abs/10.1002/alz.042589

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