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Galantamine for Alzheimer's disease
1Adult and Geriatric Treatment and Preventative Interventions Branch, National Institute of Mental Health, NIMH, Room 7160, MSC 9635, 6001 Executive Blvd., Bethesda, Maryland 20892-9635, USA. jolin@mail.nih.gov
The Cochrane Database of Systematic Reviews
|July 26, 2002
Summary
Galantamine demonstrates significant benefits for Alzheimer's disease (AD) patients, improving cognitive function and global ratings in trials of 3-6 months. Doses above 8mg/day showed consistent efficacy, with 16mg/day appearing well-tolerated and effective.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Trials
Background:
- Galantamine is a reversible acetylcholinesterase inhibitor and allosteric modulator of nicotinic receptors.
- Originally from daffodil bulbs, it is now synthesized and approved in 29 countries for Alzheimer's disease (AD).
Purpose of the Study:
- To assess the clinical effects of galantamine in patients with probable AD.
- To investigate potential moderators of galantamine's treatment effect.
Main Methods:
- Systematic review of randomized, double-blind, placebo-controlled trials of galantamine in AD patients.
- Data extraction and pooling of outcomes including ADAS-cog, CIBIC-plus, ADCS-ADL, DAD, and NPI.
- Analysis of potential moderators such as trial duration and dosage.
Main Results:
- Galantamine showed significant treatment effects at daily doses of 16-32 mg in trials of 3- to 6-months duration.
- Statistically significant improvements were observed in global ratings and cognitive function (ADAS-Cog) for doses above 8mg/day.
- Higher doses (24-32 mg/day) were associated with increased discontinuation rates, particularly at 32mg/day.
Conclusions:
- Galantamine demonstrates consistent positive effects on global ratings, cognition, ADLs, and behavior in trials of 3-6 months.
- The cognitive effect magnitude is comparable to other cholinesterase inhibitors.
- An initial dose of 16 mg/day is suggested as it balances efficacy and tolerability, with longer-term effects remaining unassessed.