Effects of Rivastigmine in a Case of Residual Schizophrenia
Bibliographic record
Abstract
Dear Editor: Among cholinestcrase inhibitors, rivastigmine is an acetylcholinesterase and butyrylcholinesterase inhibitor that is widely used in treating Alzheimer's and subcortical vascular dementias, owing to its beneficial pharmacodynamic property. Combined with antipsychotics, rivastigmine has been found effective in improving negative schizophrenia symptoms (1,9). We report a case of residual schizophrenia with predominant negative symptoms that responded to rivastigmine and risperidone. Case Report Mrs J is an Indian woman, aged 45 years, with residual schizophrenia (according to ICD-10 criteria) of 6 years' duration. She was treated with risperidone and maintained on 6 mg daily. She presented with marked psychomotor retardation, passivity, lack of initiative, poverty of speech, and poor facial expression. With strong family support, she had maintained good drug compliance and responded to risperidone, which completely controlled her positive symptoms. She developed the presenting complaints during the prior 18 months, despite regularly taking an antipsychotic. Using the clinical interview, patient observation, and additional informant information, we evaluated her baseline negative symptom complex according to the Scale for the Assessment of Negative Symptoms (SANS, 2). We also evaluated her performance in Instrumental Activities of Daily Living (IADL, 3) and on the Satisfaction with Life Scale (SWLS, 4). Further, we administered neurocognitive tests: the Halstead-Reitan Battery (5) for psychomotor speed, attention, and scanning; the Rey Auditory Verbal Learning Test (6); and the Wechsler Memory Scale-Third Edition (7) for learning and memory. We started the patient on rivastigmine tartrate 1.5 mg twice daily, titrated at monthly intervals to reach a maximum of 6 mg daily in 2 months' time and maintained along with risperidone 6 mg daily. A second SANS evaluation, done after 4 weeks of drug therapy, showed 10% improvement in negative symptoms. The combined treatment of antipsychotic and rivastigmine continued for 6 months, at which time the patient was reassessed. Wc found a notable drop of 41% from her baseline SANS score. Similarly, her baseline IADL and SWLS scores improved by 36% and 28%, respectively. Neuropsychological tests measured after 6 months showed appreciably better cognitive functions, which were directly related to the improvement in her quality of life. Discussion The neurotransmitters implicated in the pathogenesis of schizophrenia are dopamine, serotonin, glutamate, and acctylcholinc. …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".