From the Guidelines
Galantamine is used in psychiatry, primarily for the treatment of mild to moderate Alzheimer's disease and other forms of dementia, as evidenced by a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians 1.
Key Points
- Galantamine is an acetylcholinesterase inhibitor that works by increasing levels of acetylcholine in the brain, which helps improve cognitive function.
- The medication shows modest benefits in improving or stabilizing cognitive function, activities of daily living, and behavioral symptoms in patients with dementia, with 3 studies suggesting a subgroup of patients have a clinically important benefit 1.
- Common side effects include nausea, vomiting, diarrhea, and decreased appetite, which often improve with continued use, and can be minimized by taking the medication with food.
- The typical starting dose is 4 mg twice daily, gradually increasing to 8-12 mg twice daily as tolerated, with a dose-response relationship for adverse events during titration 1.
Clinical Considerations
- Galantamine should be used under the guidance of a healthcare provider, with regular monitoring to assess effectiveness and manage potential side effects.
- While primarily used for cognitive disorders, it is not typically used for other psychiatric conditions like depression, anxiety, or psychotic disorders.
- The duration of trials was less than 1 year, therefore, the long-term outcomes of treatment are unknown, and treatment is long-term, as the medication helps manage symptoms but does not cure the underlying condition 1.
From the FDA Drug Label
Galantamine is a cholinesterase inhibitor indicated for the treatment of mild to moderate dementia of the Alzheimer's type (1). The answer is yes, galantamine is used in psychiatry, specifically for the treatment of dementia of the Alzheimer's type 2.
- Key use: Treatment of mild to moderate dementia of the Alzheimer's type.
From the Research
Use of Galantamine in Psychiatry
- Galantamine is primarily used in the treatment of Alzheimer's disease, but there is growing evidence that it may also be effective in treating psychiatric disorders such as schizophrenia, major depression, bipolar disorder, and alcohol abuse 3.
- The drug's dual mechanism of action, which includes reversible inhibition of acetylcholine esterase and enhancement of the intrinsic action of acetylcholine on nicotinic receptors, may contribute to its potential benefits in psychiatry 4, 5.
- Studies have shown that galantamine can improve cognitive dysfunction and psychiatric symptoms in patients with schizophrenia, major depression, and other psychiatric disorders, although more research is needed to fully understand its effects in these areas 3.
Galantamine's Mechanism of Action
- Galantamine's ability to modulate nicotinic receptors and enhance cholinergic neurotransmission may be responsible for its potential benefits in psychiatry, as these effects can influence other neurotransmitter systems such as monoamines, glutamate, and γ-aminobutyric acid (GABA) 3, 5.
- The drug's muscarinic receptor activation may also contribute to its antipsychotic effects and improvement of cognitive dysfunction 3.
Clinical Evidence
- Several studies have demonstrated the efficacy of galantamine in improving cognitive function and global measures of change in patients with mild to moderately severe Alzheimer's disease 6, 7, 4, 5.
- Galantamine has also been shown to postpone the progression of behavioral symptoms and improve activities of daily living in patients with Alzheimer's disease 6, 5.
- While the majority of research has focused on galantamine's use in Alzheimer's disease, there is growing evidence to suggest that it may also be effective in treating psychiatric disorders, although more research is needed to fully understand its effects in these areas 3.