Long-term outpatient treatment of senile dementia with oral physostigmine.

The authors describe five patients with senile dementia of the Alzheimer type (SDAT) who were treated with oral physostigmine from 1 to 3 3/4 years. An abbreviated form of the Buschke selective reminding test was used to assess the patients' short-term verbal memory at periodic clinic visits. Although one of the patients deteriorated progressively from the start of the physostigmine therapy and was taken off the drug after 1 year, there was no evidence of deterioration in memory performance on the average in the other four patients. Equally important, this open trial provides evidence of the safety of long-term treatment with physostigmine on an outpatient basis. The authors view their results as supporting the potential value of cholinesterase inhibition as a means of forestalling memory decline in SDAT patients.