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February 01, 1988; 38 (2) Articles

Intraventricular bethanechol infusion for Alzheimer's disease

Results of double‐blind and escalating‐dose trials

R. D. Penn, E. M. Martin, R. S. Wilson, J. H. Fox, S. M. Savoy
First published February 1, 1988, DOI: https://doi.org/10.1212/WNL.38.2.219
R. D. Penn
MD
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E. M. Martin
PhD
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R. S. Wilson
PhD
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J. H. Fox
MD
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S. M. Savoy
RN
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Citation
Intraventricular bethanechol infusion for Alzheimer's disease
Results of double‐blind and escalating‐dose trials
R. D. Penn, E. M. Martin, R. S. Wilson, J. H. Fox, S. M. Savoy
Neurology Feb 1988, 38 (2) 219; DOI: 10.1212/WNL.38.2.219

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Abstract

Ten patients with biopsy-proven Alzheimer's disease (AD) received low-dose (0. 35 mg/d) intraventricular bethanechol, a muscarinic agonist, and saline placebo in a 24-week double-blind crossover design. Eight of these ten patients later participated in an open escalating-dose (to 1.75 mg/d) trial of bethanechol. Patients' drug responses were assessed by neuropsychological examination and informant measures of activities of daily living, mood disturbance, and abnormal behavior. Bethanechol appears to have a narrow therapeutic window for positive effects; low doses did not reliably alter patient functioning, moderately increased doses appeared to have a palliative effect on patient mood and behavior, and the highest dose was detrimental to patient functioning. Bethanechol does not appear to ameliorate the dementia of AD, but may exert a mildly positive effect on patient behavior and mood.

  • © 1988 by Edgell Communications, Inc.

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