OBJECTIVE: To review the historic, pharmacologic, pharmacokinetic,
therapeutic, and toxicologic features of galantamine, a new
acetylcholinesterase inhibitor, and to assess its role in the treatment of
Alzheimer disease symptoms.
DATA SOURCES: A search of articles was conducted using MEDLINE, TOXLINE,
and the literature database Psychinfo, from 1966 to June 1999. The
manufacturers, Janssen and SoPharm (Bulgaria), were contacted to obtain
relevant preclinical data. Published textbooks of meeting symposia were
also reviewed.
STUDY SELECTION: Studies with animals and humans addressing preclinical
pharmacology, human studies on pharmacokinetics, open clinical trials, and
controlled studies were evaluated.
DATA EXTRACTION: Relevant data were extracted from published studies and
meeting abstracts only.
DATA SYNTHESIS: Galantamine has an extensive record of activity as a
reversal agent for neuromuscular blockade. Galantamine is also effective
in the treatment of mild to moderate Alzheimer disease symptoms. Its
efficacy versus similar Alzheimer treatment agents has yet to be
determined. Adverse effects are gastrointestinal in nature and usually
appear during the first weeks of therapy.
CONCLUSIONS: Galantamine is a useful agent for the treatment of Alzheimer
disease and for the reversal of neuromuscular blockade. It acts as both an
acetylcholinesterase inhibitor and a nicotinic receptor agonist.
