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Variable Dose-Related Responses

Stephen L. Read, MD; John Frazee, MD; Jill Shapira, RN, MN; Cheryll Smith, PhD; Jeffrey L. Cummings, MD; Uwamie Tomiyasu, MD

Arch Neurol. 1990;47(9):1025-1030.

Abstract
• Five male patients participated in a pilot open-label study of dose-related aspects of response to intracerebroventricular bethanechol in Alzheimer's disease. No patient had remission of symptoms, but three patients improved symptomatically and on tests of memory. Improvement was evident over a restricted range of doses for each subject, and symptoms were worse at doses below and above the optimal range. There was little overlap in the range of doses producing improvement among these three. Two patients had no consistent improvement in memory, and agitation, depression, paranoia, and seizures developed during treatment. Qualitative differences and variability in dosages producing responses complicate the identification of true drug response in the treatment of Alzheimer's disease.

Author Affiliations
From the John Douglas French Center, Los Alamitos; the Departments of Psychiatry and Neurology, Harbor-UCLA Medical Center (Dr Read); Departments of Neurosurgery (Dr Frazee), Nursing (Ms Shapira), Psychology (Dr Smith), Neurology and Psychiatry (Dr Cummings), and Pathology (Dr Tomiyasu), UCLA School of Medicine and the West Los Angeles Veterans Administration Medical Center, Calif.

Footnotes
Accepted for publication November 29, 1989.

Reprint requests to John Douglas French Center, 3951 Katella Ave, Los Alamitos, CA 90720 (Dr Read).

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