Tacrine in Alzheimer's Disease

To the Editor: In his accompanying editorial (Oct. 29 issue),¹ Dr. Growdon cites the minimally positive results with tacrine in the multicenter study by Davis et al.² to argue for the abandonment of “simple replacement” cholinomimetic therapies in favor of promising futuristic restorative approaches. Although new approaches are desperately needed, we must also be diligent in our evaluation of current methods. In our view, the most likely factor responsible for the unimpressive clinical effect of tacrine may be the deletion of the higher doses (120 and 160 mg per day) from the protocol because of their propensity to cause marked…