TRANSDERMAL PHYSOSTIGMINE IN THE TREATMENT OF ALZHEIMERS-DISEASE

Physostigmine has been reported to improve the memory function of some patients with Alzheimer's Disease (AD). However, the drug has a short half-life and a narrow therapeutic window. To overcome these impedime nts, we developed a continuous transdermal delivery system and tested it for 2 weeks in 12 AD inpatients, using a single-blind design. No ma jor adverse effects were recorded in any of the patients. Physostigmin e plasma concentrations were relatively stable (0.56+/-0.10 ng/ml) and correlated well with blood acetylcholinesterase inhibition. Six of th e 12 patients reported improved vigilance and concentration, and also had higher scores in all four neuropsychological tests employed (Mini Mental State examination, Short Mental Test [SMT], Wechsler's Memory S cale [WMS], and Buschke's Selective Reminding Test). The performance o f two additional patients improved in only two tests (SMT and WMS). Tr ansdermal delivery of physostigmine appears to be safe and may be usef ul for the treatment of a subset of AD patients.