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Trial of oral physostigmine in amyotrophic lateral sclerosis
Author(s) -
Norris Forbes H,
Tan Yande,
Fallat Robert J,
Elias Linda
Publication year - 1993
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1993.206
Subject(s) - physostigmine , placebo , amyotrophic lateral sclerosis , medicine , crossover study , anesthesia , grip strength , clinical trial , physical therapy , cholinergic , alternative medicine , disease , pathology
We evaluated a double‐blind, placebo‐controlled, and double‐crossover trial of oral physostigmine salicylate for a 9‐month period in 13 of 25 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 assessment of the drug efficacy included body weight, ALS score, Jamar grip strength, forced vital capacity, and maximum voluntary ventilation. It revealed slight benefit in reduced loss of grip strength compared 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 pretrial, placebo, and physostigmine periods. We therefore concluded that overall no significant alteration in the clinical course was gained by oral physostigmine therapy in the 13 patients with ALS who were included in this study. Clinical Pharmacology and Therapeutics (1993) 54 , 680–682; doi: 10.1038/clpt.1993.206