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Important Notice: The Forum does not endorse any medical
product or therapy. ALL medications and supplements
should be taken ONLY under the supervision of a physician,
due to the possibility of side-effects, drug interactions,
etc.
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Name:
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Galantamine
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Other Names:
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Reminyl™
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Mechanisms:
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cholinesterase inhibitor
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Development Status:
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approved in U.S.
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FDA Phase:
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FDA approved
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Primary Medical Role:
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Treatment for Alzheimer's disease.
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Role in Alzheimer's Disease:
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Improve cognitive function in mild/moderate AD.
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Pharmacological Role:
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Reversible cholinesterase inhibitor.
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Contraindications:
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N/A
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Side Effects:
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Nausea, vomiting, other cholinergic effects (~10% vs. 5%
controls), particularly in early weeks of ingestion.
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Evidence pro its efficacy:
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In half of patients with mild to moderate forms of this
disease, who usually worsen over time, cognitive scores
and daily functions were maintained at or above baseline
throughout one year of treatment. In trials of 3 to 6
months' duration, recipients of galantamine 16 or 24
mg/day achieved significant improvements in cognitive and
global symptoms relative to placebo recipients.
Galantamine also improved activities of daily living in
these patients and significantly reduced the requirement
for caregiver assistance with activities of daily living.
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Evidence con its efficacy:
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It is difficult to say that this medication offers
advantages in efficacy over existing anticholinergics.
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Dosage:
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Starting dosage at 8 mg/day, increase to 16mg/day after at
least four weeks. Physicians have the flexibility to
increase the daily dose to 24 mg after an additional four
weeks.
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Notes:
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See ARF news story
published on 26 Jan 2005 and statement on Johnson & Johnson web site regarding
review of safety data.
See Medline Plus Drug Information: Galantamine [MedMaster]
and Galantamine (Systemic) [USP DI]
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Cummings JL, Schneider L, Tariot PN, Kershaw PR, Yuan W.
Reduction of behavioral disturbances and caregiver
distress by galantamine in patients with Alzheimer's
disease. Am J Psychiatry. 2004 Mar ;161(3):532-8. Abstract
Raskind MA. Update on Alzheimer drugs (galantamine).
Neurolog. 2003 Sep; 9(5):235-40. Abstract
Mintzer JE, Kershaw P. The efficacy of galantamine in the
treatment of Alzheimer's disease: comparison of patients
previously treated with acetylcholinesterase inhibitors to
patients with no prior exposure. Int J Geriatr Psychiatry.
2003 Apr;18(4):292-7. Abstract
Cummings JL. Use of cholinesterase inhibitors in clinical
practice: evidence-based recommendations. Am J Geriatr
Psychiatry. 2003 Mar-Apr ;11(2):131-45. Abstract
Davidsson P, Blennow K, Andreasen N, Eriksson B, Minthon
L, Hesse C. Differential increase in cerebrospinal fluid-
acetylcholinesterase after treatment with
acetylcholinesterase inhibitors in patients with
Alzheimer's disease. Neurosci Lett. 2001 Mar 16;300(3):157-
160. Abstract
Aerssens J, Raeymaekers P, Lilienfeld S, Geerts H, Konings
F, Parys W. APOE genotype: no influence on galantamine
treatment efficacy nor on rate of decline in Alzheimer's
disease. Dement Geriatr Cogn Disord. 2001 Mar-Apr ;12
(2):69-77. Abstract
Woodruff-Pak DS, Vogel RW, Wenk GL. Galantamine: effect on
nicotinic receptor binding, acetylcholinesterase
inhibition, and learning. Proc Natl Acad Sci U S A. 2001
Feb 13;98(4):2089-94. Abstract
Scott LJ, Goa KL. Galantamine: a review of its use in
Alzheimer's disease. Drugs. 2000 Nov;60(5):1095-122. Abstract
Sramek JJ, Frackiewicz EJ, Cutler NR. Review of the
acetylcholinesterase inhibitor galanthamine. Expert Opin
Investig Drugs. 2000 Oct;9(10):2393-402. Abstract
Bachus R, Bickel U, Thomsen T, Roots I, Kewitz H. The O-
demethylation of the antidementia drug galanthamine is
catalysed by cytochrome P450 2D6. Pharmacogenetics. 1999
Dec;9(6):661-8. Abstract
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