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Important Notice: The Forum does not endorse any medical
product or therapy. ALL medications and supplements
should be taken ONLY under the supervision of a physician,
due to the possibility of side-effects, drug interactions,
etc.
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Name:
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Physostigmine Salicylate
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Other Names:
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Synapton
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Development Status:
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investigational in U.S.
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FDA Phase:
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Discontinued
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Primary Medical Role:
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Treatment for mild-to-moderate dementia.
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Role in Alzheimer's Disease:
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Improvment of short-term memory.
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Pharmacological Role:
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Sustained-release version of physostigmine, which is an
acetylcholinesterase inhibitor.
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Side Effects:
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Nausea (45% vs. 5 % placebo); Vomiting (40% vs. 3%);
Diarrhea (12% vs. 1%); Anorexia (11% vs. 2%); Dizziness
(11% vs. 4%); Headache (9% vs. 5%); stomach pain (8.7% vs.
0.5%); sweating (8.7% vs. 0.5%); and flatulence (5% vs.
0%).
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Evidence pro its efficacy:
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In a big, double-blinded, placebo-controlled, multicenter
study, this sustained-release form of physostigmine seemed
to help improve cognitive test scores slightly.
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Evidence con its efficacy:
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It has high side effects (nausea, vomiting, diarrhea,
anorexia, dyspepsia, and abdominal pain for patients), and
its effectiveness is limited due to high drop out rate.
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Dosage:
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Up to 15 mg, twice a day.
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Companies:
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Forest Laboratories, Inc.
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Beach TG, Kuo YM, Schwab C, Walker DG, Roher AE. Reduction
of cortical amyloid beta levels in guinea pig brain after
systemic administration of physostigmine. Neurosci Lett.
2001 Sep 7;310(1):21-4. Abstract
Petrie EC, Peskind ER, Dobie DJ, Veith RC, Raskind MA.
Plasma catecholamine and cardiovascular responses to
physostigmine in Alzheimer's disease and aging.
Psychoneuroendocrinology. 2001 Feb;26(2):147-64. Abstract
Coelho F, Birks J. Physostigmine for Alzheimer's disease.
Cochrane Database Syst Rev. 2001;(2):CD001499. Abstract
Thal LJ, Ferguson JM, Mintzer J, Raskin A, Targum SD. A 24-
week randomized trial of controlled-release physostigmine
in patients with Alzheimer's disease. Neurology. 1999 Apr
12;52(6):1146-52. Abstract
Blin J, Ivanoiu A, De Volder A, Michel C, Bol A, Verellen
C, Seron X, Duprez T, Laterre EC. Physostigmine results in
an increased decrement in brain glucose consumption in
Alzheimer's disease. Psychopharmacology (Berl). 1998
Apr;136(3):256-63. Abstract
Perola E, Cellai L, Lamba D, Filocamo L, Brufani M. Long
chain analogs of physostigmine as potential drugs for
Alzheimer's disease: new insights into the mechanism of
action in the inhibition of acetylcholinesterase.
Biochim Biophys Acta. 1997 Nov 14;1343(1):41-50. Abstract
Thal LJ, Schwartz G, Sano M, Weiner M, Knopman D, Harrell
L, Bodenheimer S, Rossor M, Philpot M, Schor J, Goldberg
A. A multicenter double-blind study of controlled-release
physostigmine for the treatment of symptoms secondary to
Alzheimer's disease. Physostigmine Study Group. Neurology.
1996 Dec;47(6):1389-95. Abstract
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