May 14, 2003

VCU doctors report dementia as side effect of using thalidomide as treatment for multiple myeloma

Share this story

By Michael Ford
University News Services

RICHMOND, Va. – Doctors at the Virginia Commonwealth University Medical Center report in the New England Journal of Medicine that physicians using thalidomide to treat multiple myeloma – a cancer of the blood and immune system -- should be aware that dementia is a side effect and is reversible.

In the May 1 issue of the NEJM, the VCU physicians cite the case of a 66-year old man who was diagnosed with multiple myeloma in August 2001. In April 2002, the patient began a chemotherapy regimen that included the use of thalidomide, a drug believed to inhibit the growth of blood vessels in tumors.  By June of the same year, doctors say he became forgetful and later experienced more advanced cognitive deficits representative of dementia. 

The patient was an attorney with no previous psychiatric history.  “When the patient was initially evaluated by our team, his wife reported that he had lost his memory and had forgotten how to brush his teeth or take a shower,” said VCU’s Alexander E. Morgan, M.D., lead author on the report. “A very extensive evaluation revealed no medical cause for his dementia.”  

The physicians decided to discontinue the thalidomide when a tremor, a well-documented side effect of thalidomide, was noted.  In less than 48 hours, the patient experienced complete reversal of his dementia.  “Hopefully, more and more side effects will be noted in the medical literature as thalidomide use is further explored,” Morgan said.  

Recently, the FDA has granted permission for the formal use of thalidomide in organized studies for treating multiple myeloma patients. 

According to the U.S. Food and Drug Administration, thalidomide was first introduced in Europe in the 1950’s as a sedative and was also prescribed for nausea in pregnant women. It was found to be the cause of birth defects in children whose mothers had taken the drug in the first trimester.  At that time, the drug was never approved for sale in the United States.  Currently, thalidomide is approved for use in studies involving life-threatening diseases such as multiple myeloma where there may be no other treatment.