Oral physostigmine treatment of patients with Alzheimer's disease

Abstract

Twelve patients with Alzheimer''s disease received 0.0, 0.5, 1.0, 1.5 and 2.0 mg of oral physostigmine every 2 h for 3-5 days; symptoms after each dose were assessed with the Alzheimer''s Disease Assessment Scale. Placebo and the dose associated with the least severe symptoms were then readministered for 3-5 days each. Of the 10 patients who completed the study, 3 showed clinically who completed the study, 3 showed clinically significant improvement on the highest physostigmine dose in both phases, 4 more were marginally improved in both phases and 3 had inconsistent responses to physostigmine. Cortisol measures obtained during a sleep study suggest that patients whose symptoms improved on physostigmine were those in whom oral physostigmine enhanced central cholinergic activity.