A 24-week randomized trial of controlled-release physostigmine in patients with Alzheimer’s disease

Abstract

CR physostigmine enhanced cognitive and global function. It is relatively safe for the treatment of cognitive dysfunction secondary to AD. However, in light of the gastrointestinal side effects, a lower starting dose and a flexible titration schedule might lead to a more favorable adverse event profile in the clinical arena.

Recent Developments in Alzheimer’s Disease

“…Thus, the difference between treated and placebo groups represents approximately the equivalent of 6 to 12 months of progression. Similar results have been obtained with different AchE-I that have been studied (40)(41)(42)(43)(44).…”

Cholinesterase Inhibitor Therapies and Neuropsychiatric Manifestations of Alzheimer’s Disease

“…Psychosis and agitation scores on the BEHAVE-AD Scale (delusions, hallucinations, aggressiveness, anxiety, and affective disturbance) declined. In a study of long-acting controlled-release physostigmine, agitation was observed in 50% fewer patients treated with the drug than placebo [15]. Cholinergic abnormalities are most marked in the temporal lobes and frontal lobes, brain structures linked to mediation of emotion and NPS [8].…”

Donepezil and related cholinesterase inhibitors as mood and behavioral controlling agents

“…In two studies involving extended release physostigmine there was a significant improvement in global functioning as well as cognitive functioning when compared with placebo in mild-moderate AD patients, but the treatment was also associated with a high incidence of adverse events (in one study 78.6% of patients experienced nausea, 61.5% vomiting; in the other study 37.6% of patients discontinued the study due to adverse events) [31,32].…”