Citation

Lavon O, Eisenkraft A, Blanca M, Raveh L, Ramaty E, Krivoy A, Atsmon J, Grauer E, Brandeis R. Neurotoxicology 2015; 49: 36-44.

Affiliation

Israel Institute for Biological Research, Ness-Ziona, Israel.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.neuro.2015.05.003

PMID

26001567

Abstract

Rivastigmine, a reversible cholinesterase inhibitor, approved as a remedy in Alzheimer's disease, was suggested as pretreatment against nerve agents poisoning. We evaluated the pharmacokinetic, pharmacodynamic, physiologic, cognitive and emotional effects of repeated rivastigmine in young healthy male adults, in a double blind, placebo controlled crossover trial. Three groups completed 3 treatment periods: 0, 1.5 and 3mg twice a day, for a total of 5 intakes. Parameters monitored were: vital signs, ECG, laboratory tests, sialometry, visual accommodation, inspiratory peak flow, and cognitive function tests. Adverse reactions were mild. Peak blood levels and peak cholinesterase inhibition increased with repeated intakes, and high variability and non-linear pharmacokinetics were demonstrated. In addition, two cognitive functions were affected (perceptual speed and dynamic tracking). The complicated pharmacological profile and the high inter-personal variability limit the potential use of rivastigmine as pretreatment for war fighters and first responders.

Language: en