Sunita Somvanshi
AD-SMART Alzheimer’s Trial Launches in UK to Test ADHD and Diabetes Drugs on Dementia
If someone you care for is over 55 with a confirmed Alzheimer’s or mixed dementia diagnosis, a national UK clinical trial has opened recruitment that tests two widely used medications — one for ADHD, one for type-2 diabetes — to see whether they can slow cognitive decline. Neither drug is a cure. The trial is testing whether they can modify the course of the disease by targeting the chronic inflammation researchers believe drives Alzheimer’s progression.
The AD-SMART trial launched on 21–22 October 2026, backed by Imperial College London, the UK Dementia Research Institute, and Alzheimer’s Research UK. Chief Investigator is Professor Paresh Malhotra. The trial is recruiting 1,200 participants aged 55 and over with a confirmed Alzheimer’s or mixed dementia diagnosis, including biomarker confirmation of disease. Recruitment is running across a small number of NHS memory clinics currently open, with more than 30 sites planned as the trial expands over the coming months. The two drugs currently under evaluation are atomoxetine, an ADHD treatment, and metformin, a type-2 diabetes medication. Neither is licensed for dementia. Results from the first drugs are expected around 2030.
Families managing Alzheimer’s disease now have access to a national trial testing existing, low-cost medications — rather than waiting for new compounds to complete a decade of development. If someone in your care is over 55 with a confirmed mild-to-moderate dementia diagnosis, registration for screening is available through Join Dementia Research at joindementiaresearch.nihr.ac.uk. Do not attempt to source or self-prescribe atomoxetine or metformin independently: dosing and brain inflammation interactions are unmonitored and unproven outside the controlled trial setting.
How the Trial Is Designed to Move Faster
AD-SMART uses a multi-arm, multi-stage adaptive (MAMS) platform design, based directly on the NHS RECOVERY trial that identified effective COVID-19 treatments during the pandemic. All drug arms share a single placebo group rather than each requiring a separate control. If one drug shows insufficient effect at an interim analysis, that arm is dropped and the trial continues with remaining candidates — without halting recruitment or starting over. This structure is significantly more efficient than running separate sequential trials for each candidate.
The scientific case for both drugs rests on neuroinflammation. Researchers hypothesize that atomoxetine and metformin may modify the chronic low-grade inflammatory processes associated with Alzheimer’s progression. The trial measures whether either drug meaningfully slows cognitive decline in a real patient population, under monitored conditions.
Alzheimer’s Research UK has described the MAMS platform as potentially permanent research infrastructure: a standing clinical trial that could evaluate future repurposed drug candidates without rebuilding trial structures from scratch each time a new candidate becomes available.
What drugs are being tested in the AD-SMART trial?
The AD-SMART trial is currently testing atomoxetine, an ADHD medication, and metformin, a widely prescribed type-2 diabetes drug. Researchers hypothesize that both repurposed medications may help modify the chronic neuroinflammation associated with Alzheimer’s disease. Neither drug is licensed for dementia, and both are being evaluated under monitored trial conditions only.
Results from the first drug arms are expected around 2030. Registration is available through Join Dementia Research at joindementiaresearch.nihr.ac.uk. The adaptive design allows new drug candidates to be added to future arms as evidence develops.
