The effect of long-term physostigmine administration in Alzheimer's disease.
We assessed the effect of chronic long-term physostigmine in 20 patients with probable Alzheimer's disease. Initially, all patients went through a dose-finding phase and a double-blind crossover period, and were subsequently classified as physostigmine responders or nonresponders based on an a priori classification system. We then offered all patients long-term treatment with physostigmine regardless of their initial classification. Results revealed that responders spent significantly (p less than 0.0005) longer time periods on drug (36.1 +/- 4.6 months) than nonresponders (10.8 +/- 3.2). During a 2nd crossover period, 18 months into treatment, responders still demonstrated behavioral improvement, as assessed with the Sandoz Clinical Assessment-Geriatric Scale, whereas there were no behavioral changes observed in nonresponders. There were no effects on formal neuropsychological assessment. The results suggest that a subgroup of Alzheimer's patients benefits from long-term physostigmine therapy.
Harrell
L E
LE
Department of Neurology, Veterans Administration, Medical Center, Birmingham, AL.
Callaway
R
R
Morere
D
D
Falgout
J
J
D000544:Alzheimer Disease / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010830:Physostigmine / Q000008:administration & dosage* / Q000494:pharmacology; D013223:Statistics as Topic; D013997:Time Factors
D010830:Physostigmine