Galantamine: a cholinergic patch in the treatment of alcoholism: a randomized, placebo-controlled trial

Mann, Karl; Ackermann, Klaus; Diehl, Alexander; Ebert, D.; Mundle, Götz; Nakovics, Helmut; Reker, Thomas; Richter, Goetz M.; Schmidt, Lutz; Drießen, Martin; Rettig, K.; Opitz, K; Croissant, Bernhard

doi:10.1007/s00213-005-0243-9

Cited by 33 publications

(23 citation statements)

References 24 publications

(23 reference statements)

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“…Improvement of cognitive dysfunction by galantamine is also observed in cocaine users (27). In addition, Mann et al (28) reported that galantamine reduced the alcohol consumption of relapsed patients with alcohol dependence. These findings suggest the therapeutic potential of galantamine in psychiatric disorders.…”

Section: Introductionmentioning

confidence: 91%

Pharmacological Aspects of the Acetylcholinesterase Inhibitor Galantamine

et al. 2011

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Abstract. Several lines of evidence suggest that cholinergic deficits may contribute to the pathophysiology of psychiatric disorders as well as Alzheimer's disease. There is growing clinical evidence that galantamine, currently used for the treatment of Alzheimer's disease, may improve cognitive dysfunction and psychiatric illness in schizophrenia, major depression, bipolar disorder, and alcohol abuse. Since galantamine is a rather weak acetylcholinesterase inhibitor, but has additional allosteric potentiating effects at nicotinic receptors, it affects not only cholinergic transmission but also other neurotransmitter systems such as monoamines, glutamate, and γ-aminobutyric acid (GABA) through its allosteric mechanism. It is likely that these effects may result in more beneficial effects. To understand the underlying mechanism for the clinical effectiveness of galantamine, neuropharmacological studies have been performed in animal models of several psychiatric disorders. These studies suggest that not only the nicotinic receptor-modulating properties but also the muscarinic receptor activation contribute to the antipsychotic effect and improvement of cognitive dysfunction by galantamine. This review summaries the current status on the pharmacology of galantamine, focusing on its effect on neurotransmitter release and pharmacological studies in animal models of psychiatric disorders.

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Section: Introductionmentioning

confidence: 91%

Pharmacological Aspects of the Acetylcholinesterase Inhibitor Galantamine

et al. 2011

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“…After detoxification, 149 abstinent patients were randomized to galantamine or placebo (one patch per day) over 24 weeks. The placebo group did significantly better in time to first heavy drinking day than patients on galantamine [75]. However, secondary analyses of patients who had relapsed in both groups revealed the same number of drinking days, but significantly lower alcohol consumption with galantamine [76].…”

Section: Pharmacotherapy Trials Supporting the Reduction Conceptmentioning

confidence: 99%

“…Cholinergic agents: galantamine was the first cholinergic drug tested in patients with AD [75]. After detoxification, 149 abstinent patients were randomized to galantamine or placebo (one patch per day) over 24 weeks.…”

Section: Pharmacotherapy Trials Supporting the Reduction Conceptmentioning

confidence: 99%

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

2017

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Abstinence from alcohol has been the prevailing treatment goal for individuals with alcohol dependence (AD) within the context of specialty alcohol treatment. Yet, alcohol use has been conceptualized as existing on a continuum. Importantly, most people who meet criteria for AD and could benefit from treatment never receive treatment. About half of these individuals do not seek treatment because they report a desire to continue drinking. To increase acceptability of treatment, reductions in alcohol consumption have been examined as alternative outcomes in treatment trials for AD. The current study reviews data which indicate that long-term reduction in alcohol consumption among patients with AD is possible. Controlled studies have tested reduced alcohol consumption and show sustained improvements in drinking reductions for many patients following behavioral treatments and pharmacotherapy. Evidence-based treatment guidelines and medicines development guidance authorities have taken note of these developments and accept “intermediate harm reduction” (European Medicines Agency) or “low-risk drinking limits” (US Federal Drug Administration) as optional trial endpoints. In conclusion, while abstinence remains the safest treatment goal for individuals with AD, evidence supports that reduced drinking approaches may be an important extension in the treatment of AD.

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“…As noted above, the main CPF action mechanism is acetylcholinesterase inhibition. For example, it was demonstrated that administering cholinesterase inhibitors, galantamine or desoxypeganine, reduces alcohol consumption in alcohol-preferring rats (Doetkotte et al, 2005;Mann et al, 2006). Also, CPF decreases nicotinic alpha-7nAch receptor density (Slotkin et al, 2004), with a known role in ethanol intake and ethanol-induced sedation (Bowers et al, 2005;de Fiebre and de Fiebre, 2005).…”

Section: The Relationship Between Organophosphate Exposure and Ethanomentioning

confidence: 99%