Conley Robert R, Boggs Douglas L, Kelly Deanna L, McMahon Robert P, Dickinson Dwight, Feldman Stephanie, Ball M Patricia, Buchanan Robert W
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
Clin Neuropharmacol. 2009 Mar-Apr;32(2):69-74. doi: 10.1097/WNF.0B013E31816F2795.
Galantamine is an acetylcholinesterase inhibitor and an allosteric modulator of the alpha4beta2 and alpha7 nicotinic receptors. There are several case reports describing the potential benefits of galantamine for negative symptoms associated with schizophrenia. This secondary analysis describes the effects of galantamine on psychopathology in people with schizophrenia.
Subjects with clinically stable chronic schizophrenia were randomized to adjunctive galantamine (24 mg/d) or placebo in a 12-week double-blind trial. Symptomatology was assessed with the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression Scale. The Scale for the Assessment of Negative Symptoms (SANS) was used to measure negative symptoms.
Eighty-six patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of schizophrenia or schizoaffective disorder taking a stable dose of antipsychotic medications were randomized to adjunctive treatment with study drug (galantamine, n = 42; placebo, n = 44); 73 subjects completed the study (galantamine, n = 35; placebo, n = 38). No significant differences were found on BPRS total score (P = 0.585) or BPRS subfactor scores. Scale for the Assessment of Negative Symptoms total scores also did not decrease significantly (P = 0.106) in either group; however, galantamine treatment was associated with a greater benefit in the SANS subfactor, alogia (P = 0.007).
The lack of robust significant effects of galantamine on negative, and other symptom domains, may be due to the relatively low baseline level of these symptoms in the tested population. Galantamine may have some benefit on certain negative symptoms, particularly alogia. Studies specifically designed to address the issue of the efficacy of galantamine for negative symptoms are needed to confirm this observation.
加兰他敏是一种乙酰胆碱酯酶抑制剂，也是α4β2和α7烟碱型受体的变构调节剂。有几例病例报告描述了加兰他敏对精神分裂症相关阴性症状的潜在益处。这项二次分析描述了加兰他敏对精神分裂症患者精神病理学的影响。
在一项为期12周的双盲试验中，将临床症状稳定的慢性精神分裂症患者随机分为加用加兰他敏（24毫克/天）组或安慰剂组。使用简明精神病评定量表（BPRS）和临床总体印象量表评估症状。阴性症状评定量表（SANS）用于测量阴性症状。
86例符合《精神障碍诊断与统计手册》第四版精神分裂症或分裂情感性障碍诊断标准且服用稳定剂量抗精神病药物的患者被随机分配接受研究药物的辅助治疗（加兰他敏，n = 42；安慰剂，n = 44）；73名受试者完成了研究（加兰他敏，n = 35；安慰剂，n = 38）。BPRS总分（P = 0.585）或BPRS子因子得分无显著差异。两组的阴性症状评定量表总分也未显著降低（P = 0.106）；然而，加兰他敏治疗在SANS子因子“言语贫乏”方面有更大益处（P = 0.007）。
加兰他敏对阴性症状和其他症状领域缺乏显著作用，可能是由于受试人群中这些症状的基线水平相对较低。加兰他敏可能对某些阴性症状有一定益处，尤其是言语贫乏。需要专门设计研究来解决加兰他敏对阴性症状疗效的问题，以证实这一观察结果。
