Dr. Mark D'Esposito

You know, I wrote a paper as a resident.

You know, sometimes you're tending to say, hey, can you write this review paper for us?

And I wrote one as a resident called The Pharmacology of Cognition where I looked at all the animal literature on,

you know, giving neuromodulators acetylcholine, dopamine or whatever.

And there was a lot of animal literature supporting that this would work in humans, but what was more striking to me was that it wasn't always just a single neurotransmitter.

There were studies where you'd give dopamine and it wouldn't do anything, you give acetylcholine and it wouldn't do anything, but if you gave a low dose of both,

it would be really effective.

So these systems don't act in isolation, so we need to also study sort of how the combinations work.

And that's where another, you know, where the pharmaceutical companies have the infrastructure to do these kind of studies.

It's very hard to do in a single lab to do multiple drugs at one time, you know, and then try and look at, try and determine all the different interactions.

Yeah, anything that boosts norepinephrine can do it.

The one that we've used that's most used is guanfacine, which is actually a blood pressure medication.

So that's starting to gain some traction.

In fact, I think there was a study with brain fog for COVID showing that it improved symptoms with it.

So there's actually some trials now that are looking at guanfacine.

And so I would say anything that boosts norepinephrine would be helpful.

But then again, I don't want to leave out the other transmitters.

Serotonin, you know, increasing serotonin, increasing acetylcholine boosts other cognitive processes.

And then, you know, in a way they can help working memory.

We talked about working memory being this foundation.