The pharmacological rationale for treating vascular dementia with galantamine (Reminyl).

There is considerable evidence indicating that, as in Alzheimer's disease, the central cholinergic system is impaired in vascular dementia (VaD). Using lessons learned from Alzheimer's disease research, it has been proposed that enhancement of the cholinergic system is a rational approach to treating the symptoms of VaD. Galantamine's dual mode of action may provide a greater chance of success in treating patients with Alzheimer's disease through enhanced efficacy on the cognitive, functional and behavioural aspects of dementia. Trials are currently underway to see if this broad spectrum of efficacy extends to patients with Alzheimer's disease with cerebrovascular disease ('mixed' dementia) or VaD, as well as other conditions, and the results are eagerly awaited.