A Double-Blind, Placebo-Controlled Pilot Study of Galantamine to Improve Cognitive Dysfunction in Minimally Symptomatic Bipolar Disorder

Abstract

Episodic memory performance was improved in the galantamine treatment group but did not improve in the placebo group. In contrast, performance on 2 of the processing speed measures showed significant improvement in the placebo condition, whereas that of the patients treated with galantamine did not improve. Galantamine may thus have specific benefits for episodic memory, but not processing speed, in patients with cognitive impairment as part of bipolar disorder.

Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions

“…Quality assessed with the Jadad scale ( Table 1; eTable 1) indicated that 4 studies Keck et al, 2009;Kelly, 2008b;Schrauwen and Ghaemi, 2006) had no quality (Jadad's scale=0), 4 (Gildengers et al, 2008;Iosifescu et al, 2009;Keck et al, 2009;Koukopoulos et al, 2012) had low quality (Jadad's scale=1), 1 (Iosifescu et al, 2009) had medium quality (Jadad's scale=2), and 5 (Ae et al, 2006;Anand et al, 2012;Ghaemi et al, 2009;Lee et al, 2014) were of high quality (Jadad's scale>3). All the studies with high quality were also RCTs, while among the studies with other designs, only 1 (Iosifescu et al, 2009) included a control group, reaching a medium quality.…”

“…A small RCT in 16 participants with BD I and II minimally symptomatic reported that compared to placebo (n=10) galantamine (n=6) showed no significant effect of galantamine on depression, mania, cognitive performance, and global functioning (assessed with GAF) (Ghaemi et al, 2009).…”

“…All studies focused on the short-or medium-term treatment and none reported results on relapse prevention. Nine studies were conducted in the USA (Ae et al, 2006;Anand et al, 2012;Burt et al, 1999;Ghaemi et al, 2009;Gildengers et al, 2008;Iosifescu et al, 2009;Keck et al, 2009;Kelly, 2008a;Schrauwen and Ghaemi, 2006), 2 in Asia Lee et al, 2014) and one in Europe (Koukopoulos et al, 2012). Five studies were RCTs, 2 naturalistic case series, 2 retrospective case series, 2 open label trials without a control group and 1 with a control group.…”

“…Three studies (Ghaemi et al, 2009;Iosifescu et al, 2009;Schrauwen and Ghaemi, 2006) explored the effect of galantamine (treated=21; controls: 20, 10 placebo and 10 healthy subjects), one was a RCT (Ghaemi et al, 2009). Four studies (Anand et al, 2012;Keck et al, 2009;Koukopoulos et al, 2012;Lee et al, 2014) investigated the use of memantine (treated=152; controls=88, all placebo) with 2 studies (Anand et al, 2012;Lee et al, 2014) with a RCT design.…”

“…The 12 included studies (Ae et al, 2006;Anand et al, 2012;Burt et al, 1999;Chen et al, 2013;Ghaemi et al, 2009;Gildengers et al, 2008;Iosifescu et al, 2009;Keck et al, 2009;Koukopoulos et al, 2012;Lee et al, 2014;Schrauwen and Ghaemi, 2006) included a total of 434 participants (treated=275, controls=147) for an average follow-up period of 20 weeks. All studies focused on the short-or medium-term treatment and none reported results on relapse prevention.…”