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April 1997

Double-blind Crossover Study With Physostigmine in Patients With Degenerative Cerebellar Diseases

Author Affiliations

From the Department of Neurology, Medical University of Lübeck, Lübeck, Germany.

Arch Neurol. 1997;54(4):397-400. doi:10.1001/archneur.1997.00550160041013

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.