Olazarán J, García G
CEP Hermanos Sangro. Area 1 de Atención Especializada del Insalud. Servicio de Neurología. Hospital General Universitario Gregorio Marañón. Madrid. España.
Neurologia. 2002 Oct;17(8):429-36.
Galantamine has been recently approved for the symptomatic treatment of Alzheimer's disease (AD). Apart from inhibiting acetylcholinesterase, galantamine modulates the nicotinic receptors, although the clinical significance of this action remains uncertain. Through a broad research program, it has been shown that galantamine produces a cognitive, functional and behavioral benefit in patients with either mild or moderate AD. Initially, the maintenance dose must be 16 mg a day. Later on, 24 mg dose attempts are justified on an individual patient basis. A clinical stabilization for almost one year is observed. After that time, treated patients deteriorate at a similar pace than the non-treated ones, but they remain above the non-treated during at least one more year. Additional data suggest that positive effects of galantamine spread both caregiver burden and pharmacoeconomic areas. Tolerability is good, provided that titration is made slowly. The only contraindications of this drug are atrioventricular blockade and uncontrolled bronchospasm. Galantamine has also shown efficacy in mixed dementia. New possible indications are mild cognitive impairment and vascular dementia.
加兰他敏最近已被批准用于阿尔茨海默病（AD）的症状性治疗。除抑制乙酰胆碱酯酶外，加兰他敏还可调节烟碱受体，尽管这一作用的临床意义仍不明确。通过一项广泛的研究计划表明，加兰他敏对轻度或中度AD患者具有认知、功能和行为方面的益处。最初，维持剂量必须为每日16毫克。之后，根据个体患者情况可尝试24毫克的剂量。观察到临床稳定期将近一年。此后，接受治疗的患者与未治疗的患者以相似的速度恶化，但在至少一年多的时间里，他们的状况仍优于未治疗的患者。其他数据表明，加兰他敏的积极作用还体现在减轻照料者负担和药物经济学方面。只要缓慢滴定，耐受性良好。该药仅有的禁忌证是房室传导阻滞和未控制的支气管痉挛。加兰他敏在混合性痴呆中也显示出疗效。新的可能适应证是轻度认知障碍和血管性痴呆。
