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Limited evidenceBrain & cognition

Homotaurine

An amyloid-binding compound (also known as tramiprosate) that failed its large Alzheimer's trial. What remains is a post-hoc signal in APOE4 carriers and a few small studies in mild cognitive impairment.

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What the science says

  • No benefit in a large Alzheimer's trial Moderate evidence

    The Alphase study randomized over 1,000 patients with mild-to-moderate Alzheimer's disease to tramiprosate or placebo for 18 months and found no significant effect on cognition or global function. This is the largest and most informative trial of the compound.

  • Post-hoc signal in APOE4 homozygotes Limited evidence

    Re-analyses of the same failed trial reported a cognitive benefit concentrated in patients carrying two APOE4 alleles. These are exploratory subgroup analyses of a negative study and have not been confirmed prospectively.

  • Small studies in mild cognitive impairment Limited evidence

    Small open studies in people with mild cognitive impairment have reported changes in inflammatory markers such as IL-33 and IL-10 after homotaurine. Biomarker shifts in tiny samples say nothing reliable about memory.

Dosage & safety

Studied doseThe Alzheimer's trials used 100–150 mg twice daily. Supplements typically supply 50–100 mg per day, below the studied dose.
SafetyNausea, vomiting and dizziness were the common adverse effects in trials. It is regulated as a supplement in some countries and as an investigational drug in others. Not appropriate as a substitute for medical treatment of dementia, and untested in pregnancy.

How to take it

TimingSplit into two doses, morning and evening, as in the trials.
With food?Take it with food — nausea and vomiting were the main complaints in trials and food reduces them.
Worth knowingMost supplements supply well under the trial dose, so check the label figure against the 200–300 mg/day actually studied.

Frequently asked questions

Does homotaurine work for Alzheimer's disease?

No: homotaurine (tramiprosate) failed its large Alzheimer's trial, in which over 1,000 patients with mild-to-moderate disease showed no significant effect on cognition or global function after 18 months. This is moderate-grade evidence against a benefit.

Does homotaurine help APOE4 carriers?

The claim that homotaurine helps APOE4 carriers rests on post-hoc re-analyses of the same failed trial, which found a cognitive signal in people with two APOE4 alleles. These exploratory subgroup results have not been confirmed prospectively, so the evidence is limited.

How much homotaurine per day was used in trials?

The Alzheimer's trials of homotaurine used 100–150 mg twice daily, taken with food and split morning and evening. Most supplements supply only 50–100 mg per day, well below the dose actually studied.

What are the side effects of homotaurine?

Nausea, vomiting and dizziness were the common adverse effects of homotaurine in trials, and taking it with food helps. Homotaurine is untested in pregnancy and is not a substitute for medical treatment of dementia.

Scientific references

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