Safety and efficacy of oral physostigmine in the treatment of Alzheimer disease.
Author(s): Sano M, Bell K, Marder K, Stricks L, Stern Y, Mayeux R.
Affiliation(s): Department of Neurology, Columbia University, College of Physicians and Surgeons,
New York, New York.
Publication date & source: 1993, Clin Neuropharmacol. , 16(1):61-9
Results of therapeutic trials with physostigmine in the treatment of Alzheimer
disease (AD) have been inconsistent and controversy persists concerning safety
and efficacy. In a double-blind, placebo-controlled, crossover study, patients
received 6 weeks of oral physostigmine (OP) and placebo in random order.
Twenty-nine patients with AD received as much as 16 mg/day of OP and were
assessed with neuropsychological and functional measures. No significant cardiac
side effects were noted, though other systemic adverse effects were noted,
requiring dose reduction in four patients. There was a slight but significant
improvement (12%) in performance on the selective reminding test with
physostigmine and the memory performance was correlated with dosage. This
improvement compares favorably with the 15% decrease in scores seen in an
untreated comparison cohort followed for an equivalent time period. There was a
trend toward an improvement in communication and a reduction in memory complaint.
These results suggest that oral physostigmine is safe and may improve memory in
AD.
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