CLINICAL USE OF CHOLINESTERASE CLINICAL USE OF CHOLINESTERASE INHIBITORS INHIBITORS Can one switch or combine cholinesterase Can one switch or combine cholinesterase inhibitors with other drugs with real inhibitors with other drugs with real

spectrum disorders. Cholinergic changes such as a decreased ChAT activity in striatum and thalamus and a decrease in nicotinic receptors in cerebral cortex have supported these interventions in order to ameliorate the attention deficit of these patients (see Chapter 5). Several small clinical studies (3-32 patients, 4-12 weeks) have been performed on treating autistic spectrum disorders in children: decrease in irritability and hyperactivity, as well as gains in both expressive speech and overall autistic behavior, were seen. These improvements were statistically significant and supported the hypothesis that cholinergic stimulation may be useful in autism and may provide a safer alternative to the use of ritalin or other psychostimulants. Limited and transient side effects were reported with ChEIs. The drugs tested so far are galantamine, rivastigmine, and donepezil.