Abstract
The cholinergic hypothesis proposes that well-defined deficits in cholinergic neurotransmission contribute to cognitive dysfunction in Alzheimer’s disease (AD), and that enhancing cholinergic transmission will lead to improved outcome (1). Several acetylcholinesterase inhibitors (AChEI) have been approved during the past few years on the basis of clinical trials, demonstrating that these agents improve or maintain cognitive function in patients with possible AD. Thus far all AChEI have been shown to be efficacious as a class and are considered a mainstay of AD treatment. Galantamine is the newest member of this class of agents at present.
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References
Bartus, R.T. et al.: The cholinergic hypothesis of geriatric memory dysfunction. Science 1982; 217: 408–414.
Levin, E.D.; Simon, B.B.: Nicotinic acetylcholine involvement in cognitive functions in animals. Psychopharmacology 1998; 138: 217–230.
Whitehouse, P.J. et al.: Alzheimer’s disease and senile dementia: loss of neurons in the basal forebrain. Science 1982; 215: 1237–1239.
Schroeder, H. et al.: Nicotinic cholinoreceptive neurons of the frontal cortex are reduced in Alzheimer’s disease. Neurobiol Aging 1991; 12: 259–262.
Nordberg, A.; Lundqvist, H.; Hartvig, P.: Kinetic analysis of regional (S) (-) 11C- nicotinic binding in normal and Alzheimer brains in vivo assessment using positron emission tomography. Alzheimer’s Dis Assoc Disord 1995; 9: 21–27.
Perry, E. et al.: Alteration in nicotinic binding sites in Parkinson’s disease, Lewy body dementia and Alzheimer’s disease: possible index of early neuropathology. Neuroscience 1995; 64: 385–395.
Decker, M.W.: Animal models of cognitive functions. Crit Rev Neurobiol 1995; 9: 321–343.
Levin, E.D.; Rezvani, A.H.: Development of nicotinic drug therapy for cognitive disorders. Eur J Pharmacol 2000; 393: 141–146.
Parks, R.W. et al.: Increased regional cerebral glucose metabolism and semantic memory performance in Alzheimer’s disease: a pilot double-blind transdermal nicotine positron emission tomography study. Neuropsychol Rev 1996; 6: 61–79.
Maelicke, A.; Albuquerque, E.X.: Allosteric modulation of nicotinic acetylcholine receptors as a treatment strategy for Alzheimer’s disease. Eur J Pharmacol 2000; 393: 165–170.
Inestrosa, N.C. et al.: Acetylcholinesterases accelerate assembly of amyloid B-peptides into Alzheimer’s fibrils: possible role of the peripheral site of the enzyme. Neuron 1996; 16: 881–889.
Williams, M.; Arneric, S.P.: Alzheimer’s disease: prospects for treatment in the next decade. In: Brioni, J.D.; Decker, M.W. (eds.): Pharmacological treatment of Alzheimer’s disease. Wiley-Liss, New York, 1997: 525–542.
Meyer, E.M. et al.: Cytoprotective actions of nicotinic receptor stimulation (abst). Fifth Int Conf Alzheimer’s Disease and Related Disorders, Osaka, Japan, 1996.
Lopez, O.L. et al.: Cholinesterase inhibitor treatment alters the natural history of Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2002; 72: 310–314.
Rosen, W.G.; Mohs, R.C.; Davis, K.L.: A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141: 1356–1364.
Torfs, K.; Feldman, H., on behalf of the Sabeluzole Study Groups. 12-month decline in cognitive and daily function in patients with mild to-moderate Alzheimer’s disease: two randomized, placebo-controlled studies (poster). World Alzheimer Congress, Washington, DC, July 9–13, 2000.
Bartus, R.T.: On neurodegenerative diseases, models and treatment strategies, lessons learned and lessons forgotten a generation following the cholinergic hypothesis. Exp Neurol 2000; 163: 495–529.
Cummings, J.L.; Kaufer, D.: Neuropsychiatric aspects of Alzheimer’s disease: the cholinergic hypothesis revisited. Neurology 1996; 47: 876–883.
Tariot, P.N. et al.: A 5-month, randomized placebo-controlled trial of galantamine in Alzheimer’s disease. Neurology 2000; 54: 2269–2276.
Raskind, M.A. et al. and the Galantamine USA-1 Study Group: Galantamine in AD: a 6-month randomized placebo-controlled trial with a 6-month extension. Neurology 2000; 54: 2261–2268.
Wilcock, G.K.; Lilienfeld, S.; Gaens, E. on behalf of the Galantamine International-1 Study Group. Efficacy and safety of galantamine in patients with mild to moderate Alzheimer’s disease: multicenter randomized controlled trial. Br Med J 2000; 321: 1445–1449.
Wilkinson, D.; Murray, J.: Galantamine: a randomized, double-blind, dose comparison in patients with Alzheimer’s disease. Int J Geriatr Psychiatry 2001; 16: 852–857.
Rockwood, K. et al.: Effects of flexible galantamine dose in Alzheimer’s disease: a randomized, controlled trial. J Neurol Neurosurg Psychiatry 2001; 71: 589–595.
Raskind, M.A.; Peskind, E.; Truyen, L.: Galantamine provides long-term cognitive benefits for at least 36 months in patients with Alzheimer’s disease (poster). American Psychiatric Association 155th Annual Meeting, Philadelphia, May 18–23, 2002.
Farlow, M.R. et al.: Treatment outcome of tacrine therapy depends on apolipoprotein genotype and gender of the subjects with Alzheimer’s disease. Neurology 1998; 50: 669–677.
Erkinjutti, T. et al: Efficacy of galantamine in probable vascular dementia and Alzheimer’s disease combined with cerebrovascular disease: a randomized trial. Lancet 2002; 1359: 1283–1290.
Small, G.W.; Lilenfield, S.: Galantamine demonstrates sustained cognitive benefits in patients with Alzheimer’s disease, vascular dementia, or Alzheimer’s disease with cerebrovascular disease (poster). American Psychiatric Association 155th Annual Meeting, Philadelphia, May 18–23, 2002.
Leber, P.: Guidelines for the clinical evaluation of anti-dementia drugs, 1st draft. U.S. Food and Drug Administration, Rockville, MD, 1990.
Feldman, H. et al.: The disability assessment for dementia scale: a 12-month study of functional ability in mild to moderate severity Alzheimer’ disease. Alzheimer’s Dis Assoc Disord 2001; 15: 89–95.
Mintzer, J.E.; Faison, W.E.: Prolonged benefits with acetylcholinesterase inhibitors are exhibited in patients with Alzheimer’s disease (poster). American Association for Geriatric Psychiatry 15th Annual Meeting, Orlando, Fla, February 24–27, 2002.
Tariot, P.N.; Blazina, L.: The psychopathology of dementia. In: Morris, J. (ed.): Handbook of dementing illnesses. Marcel Decker, New York, 1993: 461–475.
Burke, E.; Lilienfeld, S.: Galantamine improves behavior and reduces caregiver distress in patients with Alzheimer’s disease, vascular dementia, or Alzheimer’s disease with cerebrovacular disease (poster). American Psychiatric Association 155th Annual Meeting, Philadelphia, May 18–23, 2002.
Tariot, P.N.: Treating non-cognitive problems: other classes of psychotropics in dementia. In: Qizilbash, N.; et al. (eds.): Evidence-based practice of dementia. Blackwell, Oxford, UK, 2002: 671–694.
Feldman, H. et al.: A 24-week randomized, double blind study of donepezil in moderate to severe Alzheimer’s disease. Neurology 2001; 57: 613–620.
Wilcock, G.; Lilienfeld, S.: Galantamine alleviates caregiver burden in Alzheimer’s disease: a 6- month-placebo-controlled study (poster). World Alzheimer’s Congress, Washington, DC, July 9–18, 2000.
Lilenfeld, S.; Gaens, E.: Galantamine alleviates caregiver burden in Alzheimer’s disease: a 12-month study (poster). 5th Congress European Federation of Neurological Studies, Copenhagen, October 14–18, 2000.
Getsios, D. et al.: The AHEAD Study Group. Assessment of Health Economics in Alzheimer’s Disease (AHEAD): galantamine treatment in Canada. Neurology 2002; 57: 972–978.
Ernst, R.L. et al.: Cognitive function and cost of Alzheimer disease. Arch Neurol 1997; 54: 687–693.
Knopman, D. et al.: Long term tacrine treatment: effects on nursing home placement and mortality: tacrine study group. Neurology 1996; 47: 166–177.
Kaye, J.; Schneider, L.S.; Qizilbash, N.: Therapies for cognitive symptoms, disease modification and prevention. In: Qizilbash, N.; et al. (eds.): Evidence-based practice of dementia. Blackwell, Oxford, UK, 2002: 461–588.
Qizilbash, N.; Schneider, L.S.: Summary, practical recommendations and opinion on therapies for cognitive symptoms, disease modification and prevention. In: Qizilbash, N.; et al. (eds.): Evidence-based practice of dementia. Blackwell, Oxford, UK, 2002: 560–588.
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Ismail, M.S., Tariot, P.N. (2004). Galantamine in Treatment of AD. In: Richter, R.W., Richter, B.Z. (eds) Alzheimer’s Disease. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-661-4_22
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DOI: https://doi.org/10.1007/978-1-59259-661-4_22
Publisher Name: Humana Press, Totowa, NJ
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