Role of Medium Chain Triglycerides (Axona®) in the Treatment of Mild to Moderate Alzheimer's Disease

Am J Alzheimers Dis Other Demen. 2014 Aug;29(5):409-14. doi: 10.1177/1533317513518650. Epub 2014 Jan 9.


Treatment of Alzheimer's disease (AD) with acetylcholinesterase inhibitors or N-methyl-D-aspartate (NMDA) receptor antagonists provides symptomatic relief but do not prevent its progression. Thus, additional approaches aimed at slowing the progression of the disease have been investigated. Reports detailing reduced brain glucose metabolism in the early stages of AD led to the hypothesis that alternate energy sources aimed at increasing neuronal metabolism may protect neurons and thus benefit patients with AD. Medium-chain triglycerides (MCTs) are metabolized to ketone bodies that serve as an alternative source of energy for neurons. Data from clinical trials suggest that MCTs improve cognition in patients with mild to moderate AD in apolipoprotein E4-negative patients. Adverse events observed were mild and included minor gastrointestinal problems such as diarrhea, dyspepsia, and flatulence. However, since genomic profiles are not routinely conducted in patients with AD in a clinical setting, the role of MCTs in clinical practice seems to be minimal.

Keywords: APOE4; Alzheimer’s disease; Axona®; caprylidene; ketasyn; ketogenic agents; medium-chain triglycerides; β-hydroxybutyrate.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Food, Formulated*
  • Humans
  • Ketone Bodies / metabolism*
  • Triglycerides / adverse effects
  • Triglycerides / pharmacology*


  • Ketone Bodies
  • Triglycerides