Physostigmine (0.25 mg-1 mg), arecoline (2 and 4 mg) and saline were administered intravenously over 30 minutes in a randomized double blind design to 11 patients with a clinical diagnosis of Alzheimer presenile dementia. Significant improvement was seen on a picture recognition test with physostigmine 0.375 mg and arecholine 4 mg. A trend towards improvement was also seen with physostigmine 0.25 mg and 0.75 mg, and arecholine 2 mg. For the majority of the patients improvement was only slight but in two patients it was clear cut and consistent.

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In-patients suffering from major depressive disorder (endogenous subtype) were randomly allocated to treatment by either traditional ECT with constant-voltage modified sine-wave stimuli (n = 17) or modern, constant-current brief-pulse ECT (n = 14). All treatments were bilateral and monitored by simultaneous recording by EEG. The severity of depressive illness was assessed the day before treatment, after three treatments, and seven days after the last treatment. The improvement and final depression rating scores, the likelihood of recovery, and the average number of treatments received were virtually identical in the two groups. We concluded that the policy of bilateral suprathreshold modern ECT monitored by EEG is as efficacious as traditional ECT.

SYNOPSISSerum and CSF choline levels were measured in 12 patients with pre-senile Alzheimer's disease before and 1 hour after administration of 1·5 g choline chloride or 25 g lecithin granules. Serum choline levels were increased threefold and CSF choline levels by 72%. CSF choline levels in the untreated Alzheimer patients did not differ significantly from age-matched controls. In 35 neurological controls, CSF choline levels increased with age (γ = 0·64, P<0·001).Choline influx into erythrocytes from 10 male and female Alzheimer patients did not differ significantly from 40 male and 43 female controls. Choline influx into erythrocytes was not related to age or sex, although the range was greater (P <0·05) in females than in males.Our results indicate that there is no impairment of choline transport into CSF or erythrocytes in patients with pre-senile Alzheimer's disease.