Penn R D, Martin E M, Wilson R S, Fox J H, Savoy S M
Department of Neurological Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Neurology. 1988 Feb;38(2):219-22. doi: 10.1212/wnl.38.2.219.
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.
10名经活检证实患有阿尔茨海默病（AD）的患者，在一项为期24周的双盲交叉设计中，接受了低剂量（0.35毫克/天）的脑室注射毒蕈碱激动剂氨甲酰甲胆碱，以及生理盐水安慰剂。这10名患者中的8名后来参与了氨甲酰甲胆碱的开放剂量递增（至1.75毫克/天）试验。通过神经心理学检查以及对日常生活活动、情绪障碍和异常行为的知情者测评来评估患者的药物反应。氨甲酰甲胆碱似乎具有产生积极效果的狭窄治疗窗；低剂量并不能可靠地改变患者的功能，适度增加剂量似乎对患者的情绪和行为有缓解作用，而最高剂量对患者功能有害。氨甲酰甲胆碱似乎不能改善AD的痴呆症状，但可能对患者的行为和情绪产生轻微的积极影响。
