Kumar V, Smith R C, Sherman K A, Ashford W, Murphy J, Giacobini E, Colliver J
Department of Psychiatry, Southern Illinois University School of Medicine, Springfield 62794-9230.
Int J Clin Pharmacol Ther Toxicol. 1988 Oct;26(10):471-6.
Patients with Alzheimer's disease participated in a trial of two sessions in which they received physostigmine and neostigmine in a double-blind crossover design. Most of these patients subsequently participated in a scopolamine vs saline double-blind crossover trial using a similar design. Physostigmine increased plasma cortisol relative to neostigmine, with the greatest difference at time points greater than 90 min post drug oral administration. Physostigmine also significantly decreased plasma cholinesterase (ChE). There was a significant positive correlation between the effects of physostigmine on increasing cortisol and decreasing ChE; there was no correlation between the increase in cortisol of cholinesterase inhibitor following neostigmine administration, but neither of these chemical parameters is related to the drug's effects on cognitive functioning.
患有阿尔茨海默病的患者参与了一项分两个阶段的试验，试验采用双盲交叉设计，让他们接受毒扁豆碱和新斯的明。这些患者中的大多数随后又参与了一项采用类似设计的东莨菪碱与生理盐水双盲交叉试验。与新斯的明相比，毒扁豆碱使血浆皮质醇升高，在药物口服后90分钟以上的时间点差异最大。毒扁豆碱还显著降低了血浆胆碱酯酶（ChE）。毒扁豆碱在增加皮质醇和降低ChE方面的作用之间存在显著正相关；新斯的明给药后胆碱酯酶抑制剂使皮质醇增加，但这两个化学参数均与药物对认知功能的影响无关。
