Double-blind crossover study with physostigmine in patients with degenerative cerebellar diseases.

OBJECTIVE

To determine whether treatment with physostigmine can improve the conditions of patients with ataxia.

DESIGN

A double-blind crossover study with physostigmine was performed in 19 patients with degenerative cerebellar diseases.

SETTING

Patients were selected from an ongoing prospective follow-up study at the university hospital in Lübeck, Germany.

PATIENTS

Eleven patients with autosomal dominant cerebellar ataxia and 8 patients with idiopathic cerebellar ataxia.

INTERVENTION

Physostigmine was administered by using a transdermal system (patch) containing 30 mg of physostigmine as a base, of which about 6 mg is released during 24 hours along a diffusion gradient. Each treatment phase with the physostigmine patch or the placebo lasted 4 weeks, after which the treatment of patients was crossed over to the other phase.

MAIN OUTCOME MEASURES

Ataxia was documented and quantified by using a clinical score and posturographic measures.

RESULTS

Physostigmine patches had no significant effect on cerebellar symptoms.

CONCLUSION

Treatment with physostigmine does not improve the conditions of patients with ataxia.