TRIAL OF ORAL PHYSOSTIGMINE IN AMYOTROPHIC-LATERAL-SCLEROSIS

We evaluated a double-blind, placebo-controlled, and double-crossover trial of oral physostigmine salicylate for a 9-month period in 13 of 2 5 patients with sporadic amyotrophic lateral sclerosis (ALS). A large dropout rate of 48% was secondary to eight deaths and four exclusions attributed to the incapability to swallow the tablets (physostigmine) and capsules (lecithin) or to attend the clinic. Parameters used for a ssessment of the drug efficacy included body weight, ALS score, Jamar grip strength, forced vital capacity, and maximum voluntary ventilatio n. It revealed slight benefit in reduced loss of grip strength compare d with the pretrial and placebo periods. However, the rates of decline for body weight, ALS score, forced vital capacity, maximum voluntary ventilation, and megascore did not differ significantly between the pr etrial, placebo, and physostigmine periods. We therefore concluded tha t overall no significant alteration in the clinical course was gained by oral physostigmine therapy in the 13 patients with ALS who were inc luded in this study.