Galantamine supplement information by Ray Sahelian, M.D. Health benefit and side effects of galantamine

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Galantamine information
Galantamine supplement
MInd Power Rx -- brain boosting formula

Galantamine is a cholinergic medicine. Galantamine can be isolated from several plants, including daffodil bulbs, but is now synthesized. Galantamine is available over the counter and also by prescription.
   Galantamine offsets reductions in central cholinergic neurotransmission in Alzheimer's disease by specifically and reversibly inhibiting the acetylcholinesterase enzyme. This allows more acetylcholine to be available in the brain. Galantamine is also a nicotinic receptor agonist. Another herbal extract that has potential in the therapy of Alzheimer's disease is Huperzine A.
   Being approved for the treatment of Alzheimer's disease in both the US and in Europe, galantamine has potential as therapy for dementia. Galantamine is currently not recommended for use by young individuals.

Galantamine side effects
Side effects of galantamine are similar to those of other cholinesterase inhibitors. High doses may lead to side effects such as nausea, vomiting, diarrhea, abdominal pain, and dyspepsia.

GalantaMind is a formulation featuring galantamine, a phytonutrient extracted from the common snowdrop (Galanthus nivalis), daffodil (Narcissus pseudonarcissus L.), and spider lily (Lycoris radiata), among other plants.

NOTE: Please consult with your physician before you purchase galantamine to make sure this product is appropriate for you. Galantamine is also sold as Reminyl, a prescription medicine.

Galantamine supplement facts
Vitamin B5 - 100 mg (from calcium pantothenate)
Galantamine hydrobromide extract - 4 mg (Galanthus nivalis)           
Choline -  200 mg (from choline dihydrogen citrate)

Mind Power Rx - Formulated by Ray Sahelian, M.D.

Mind Power Rx is a sophisticated cognitive formula. It combines a delicate balance of brain circulation agents and neurotransmitter precursors with powerful natural brain chemicals that support:

• Memory and Mood
• Mental clarity
• Concentration 
• Alertness & Focus

Why buy all the individual herbs and nutrients separately -- at great expense -- when you can buy this excellent combination?
   The herbs in Mind Power Rx include: Ashwagandha, Bacopa, Fo-Ti, Ginkgo biloba,  Ginseng, Gotu kola, Mucuna pruriens, Reishi, and Rhodiola.  The nutrients and vitamins in Mind Power Rx include Acetyl-l-carnitine, Carnitine, Carnosine, Choline, DMAE, Inositol, Methylcobalamin, Pantothenic acid, Trimethylglycine, Tyrosine, and Vinpocetine.

Click Galantamine above in blue for more information

Galantamine for Nerve Gas Exposure
Treatment with galantamine in combination with atropine, protects guinea pigs from lethal doses of the nerve agents sarin and soman and the insecticide parathion. The toxic effect of these "organophosphorus" compounds derives from irreversible blockage of an enzyme critical to nerve function. The end result can be seizures and cardiac arrest. At present, atropine and other drugs are used to treat the toxic effects of organophosphorus compounds. However, these treatments have various limitations, including an inability to fully protect the brain from damage. Galantamine protects nerves from these chemicals by temporarily blocking the same enzyme. Researchers tested the effects of galantamine in guinea pigs exposed to lethal doses of sarin, soman, and paraoxon, the biologically active form of parathion. Atropine was given to counter the effects of these agents outside the brain. Galantamine plus atropine safely and effectively counteracted the toxic effects of the organophosphorus compounds. Moreover, galantamine was well tolerated at the dosages needed to prevent death. Proceeding of the National Academy of Sciences, August 2006.

Galantamine Research Update
Indicators of neuroprotection with galantamine.
Brain Res Bull. 2005 Jan 30;64(6):519-24. Geerts H.
In Silico Biosciences, 686 Westwind Drive, Berwyn, PA
Alzheimer's disease is pathologically characterized by neurofibrillary tangles and beta-amyloid plaques. These observations form the basis for a large number of disease-modifying therapeutic approaches, which might ultimately lead to neuroprotection and enhanced survival of neurons. Recent data suggest a role for cholinergic stimulation, especially the alpha7 nicotinic acetylcholine receptors (nAChR), in beta-amyloid-mediated neurotoxicity. As galantamine is a modest acetylcholinesterase inhibitor in addition to being an allosteric modulator of nicotinic acetylcholine receptors, it is interesting to study the clinical effects of this compound in the light of its neurochemical properties to discern potential neuroprotective effects. The review presents the preclinical evidence in Alzheimer-related models of neuroprotection with galantamine, especially in models related to glutamate and beta-amyloid toxicity in vitro and to cholinergic stress in vivo. There is substantial evidence that these effects occur by upregulation of the protective protein bcl-2 and are mediated via alpha7 nicotinic acetylcholine receptors. The review also identifies possible clinical indicators, such as long-term studies, suggesting a neuroprotective effect for galantamine mediated by alpha7 nicotinic receptors. These clinically relevant neuroprotective properties of galantamine are worthwhile exploring further and their clinical relevance may improve the development of new disease-modifying agents.

Galantamine for Alzheimer's disease.
Cochrane Database Syst Rev. 2004 Oct 18(4)
Galantamine is a specific, competitive, and reversible acetylcholinesterase inhibitor. To assess the clinical effects of galantamine in patients with probable or possible Alzheimer's disease (AD), and potential moderators of effect. The trials were identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group, last updated on 25 August 2005 using the terms galanthamin*, galantamin* and Reminyl. Published reviews were inspected for further sources. Additional information was collected from unpublished clinical research reports for galantamine obtained from Janssen. Trials selected were randomised, double-blind, parallel-group comparisons of galantamine with placebo for a treatment duration of greater than 4 weeks in subjects with AD. Seven trials with a total 3777 subjects were included in the analysis. Treatment with galantamine led to a significantly greater proportion of subjects with improved or unchanged global rating scale rating (k=7), at all dosing levels except for 8mg/d. Treatment with galantamine also led to significantly greater reduction in ADAS-cog score at all dosing levels (k=7), with greater effect over 6 months compared to 3 months. Galantamine's adverse effects appeared similar to those of other cholinesterase inhibitors and to be dose related. Galantamine's effect on more severely impaired subjects has not yet been assessed. Nevertheless, this review shows consistent positive effects for galantamine for trials of 3 to 6 months duration. Although there was not a statistically significant dose-response effect, doses above 8mg/d were, for the most part, consistently statistically significant. Galantamine's safety profile is similar to that of other cholinesterase inhibitors with respect to cholinergically mediated gastrointestinal symptoms. It appears that doses of 16 mg/d were best tolerated in the single trial where medication was titrated over a 4 week period, and because this dose showed statistically indistinguishable efficacy with higher doses, it is probably most preferable initially. Longer term use of galantamine has not been assessed in a controlled fashion.

Long-term outcomes of galantamine treatment in patients with Alzheimer disease.
Am J Geriatr Psychiatry. 2004 Sep-Oct;12(5):473-82.
The authors evaluated the long-term safety, efficacy, and tolerability of galantamine 24 mg/day in the treatment of Alzheimer disease by means of a 12-month, open-label extension of an earlier 5-month, double-blind, placebo-controlled trial with a 6-week withdrawal phase. Patients completing two double-blind, placebo-controlled trials (N=699) were escalated to a 24-mg dose (12 mg bid) of galantamine during a period of 2 weeks and treated for 12 months beyond the initial 6.5-month, double-blind period (total treatment duration: 18.5 months). The primary efficacy measure was the change from baseline in the Alzheimer's Disease Assessment Scale (ADAS-Cog/11) score at 18.5 months; secondary endpoints included total scores on the Alzheimer's Disease Cooperative Study of Activities of Daily Living and the Neuropsychiatric Inventory. Standard safety evaluations, including adverse-event monitoring, were performed. Patients taking galantamine continuously throughout the double-blind and open-label studies (N=288) showed sustained cognitive benefits on ADAS-Cog/11 scores at 18.5 months. Patients were maintained close to baseline cognitive ability for 12 months, and safety was as expected and documented in other large studies of galantamine. Analysis of the subgroup of patients (N=113) who completed the entire 18.5 months of galantamine treatment showed that cognitive function was maintained up to 14 months. Results of this open-label extension support the findings from previous galantamine studies and demonstrate the safety and tolerability of galantamine for up to 18.5 months.

Galantamine from snowdrop--the development of a modern drug against Alzheimer's disease from local Caucasian knowledge.
J Ethnopharmacol. 2004 Jun;92(2-3):147-62.
In recent years, galantamine isolated from several members of the Amaryllidaceae (Leucojum spp., Narcissus species, Galanthus spp.) has become an important therapeutic options used to slow down the process of neurological degeneration in Alzheimer's disease. This review traces aspects of the history of its development from little known observational studies in the Caucasus Mountains (Southern Russia), to the use of galantamine in Eastern European countries (esp. Bulgaria) in the treatment of poliomyelitis and ultimately to the recent introduction onto Western markets in the treatment of Alzheimer's disease. Of note, little is known about the early history of the galantamine's development and the review also points to other gaps in our knowledge about the ethnopharmacology, pharmacology and clinical use of galantamine.

Clinical pharmacokinetics of galantamine.
Farlow MR. Indiana University School of Medicine, Indianapolis, Indiana
Clin Pharmacokinet. 2003;42(15):1383-92.
Galantamine is the most recently approved cholinergic drug for the treatment of Alzheimer's disease, the most common type of dementia. Vascular dementia and Alzheimer's disease with cerebrovascular disease are also common in older patients. Treatments for dementia, particularly Alzheimer's disease, have focused on improving function in the cholinergic system. Vascular dementia and diffuse Lewy body dementia are also associated with significant defects in cholinergic function. Galantamine works by inhibiting acetylcholinesterase and by allosterically modulating nicotinic receptors. In clinical trials, galantamine has shown benefits in the domains of cognition, function in activities of daily living, and behaviour. Galantamine is about 90% bioavailable and displays linear pharmacokinetics. It has a relatively large volume of distribution and low protein binding. Metabolism is primarily through the cytochrome P450 system, specifically the CYP2D6 and CYP3A4 isoenzymes. Population pharmacokinetic modelling with galantamine has shown that the variables affecting clearance are age, sex, and bodyweight. Model simulations demonstrate the importance of a slower dose-escalation schedule in patients with moderate hepatic impairment. In several large trials, galantamine has been shown to be well tolerated, with most adverse events being mild-to-moderate and gastrointestinal in nature. Based on the literature and clinical trial experience, galantamine appears to be an excellent treatment option for patients with Alzheimer's disease, vascular dementia or Alzheimer's disease with cerebrovascular disease.

The cognitive benefits of galantamine are sustained for at least 36 months: a long-term extension trial.
Raskind MA. University of Washington School of Medicine Seattle 98108, USA.
Arch Neurol. 2004 Feb;61(2):252-6.
Alzheimer disease (AD) causes progressive cognitive and functional decline over years. Although cholinesterase inhibitors have demonstrated efficacy in studies lasting 3 to 6 months, little is known about long-term therapy. To report the long-term cognitive effects of galantamine hydrobromide given continuously for 36 months in AD patients. Subjects were 194 US patients with mild to moderate AD who had been randomized to continuous galantamine therapy in either of 2 double-blind placebo-controlled trials. Subjects subsequently received open-label continuous galantamine therapy for up to 36 months. Effects on cognition were analyzed as change from study enrollment baseline in scores on the Alzheimer's Disease Assessment Scale-11-item cognitive subscale. Cognitive decline in galantamine-treated subjects was compared with that in a clinically similar historical control sample of AD patients who had received placebo for 12 months and with the mathematically predicted decline of untreated patients over 36 months. The rate of cognitive decline of patients who completed the entire 36-month trial (n = 119) was compared with that of patients who withdrew for any reason during the long-term open-label extension (n = 75). An inverted responder analysis was also performed in 36-month completers. Patients treated continuously with galantamine for 36 months increased a mean +/- SE of 10 points on the Alzheimer's Disease Assessment Scale-11-item cognitive subscale-a substantially smaller cognitive decline (approximately 50%) than that predicted for untreated patients. Patients discontinuing galantamine therapy before 36 months had declined at a similar rate before discontinuation as those completing 36 months of treatment. Almost 80% of patients who received galantamine continuously for up to 36 months seemed to demonstrate cognitive benefits compared with those predicted for untreated patients. Cognitive decline over 36 months of continuous galantamine treatment was substantially less than the predicted cognitive decline of untreated patients with mild to moderate dementia. Thus, the cognitive benefits of galantamine seemed to be sustained for at least 36 months. These findings suggest that galantamine slows the clinical progression of AD.

Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial.
JAMA. 2004 Sep 8;292(10):1195-204.
There is no established pharmacological treatment for the core symptoms of chronic fatigue syndrome (CFS). Galantamine hydrobromide, an acetyl cholesterone inhibitor, has pharmacological properties that might benefit patients with chronic fatigue syndrome. To compare the efficacy and tolerability of galantamine hydrobromide in patients with CFS. A total of 89 patients were randomly assigned to receive 2.5 mg of galantamine hydrobromide; 86 patients, 5.0 mg; 91 patients, 7.5 mg; and 86 patients, 10 mg (these patients received medicine in the tablet form 3 times per day); a total of 82 patients received matching placebo tablets 3 times per day. This trial did not demonstrate any benefit of galantamine over placebo in the treatment of patients with CFS.

Galantamine supplement emails
Q. What are the differences between galantamine supplement and the physician prescribed Reminyl prescription drug?
   A. This is a good question. As far as we know, they are identical, but we really have not seen the exact chemical analysis of Reminyl drug to know for sure.

Q. I wish to take galantamine for memory I not worried about it and the stoke. My main concern was about the safety of galantamine after hearing something about Reminyl for Alzheimer's and 16 people dieing in trials. can you give you input?
   A. I don't have enough personal and professional experience with galantamine to make any recommendations. We suggest having approval by your doctor. I prefer other mind nutrients and consider galantamine as a supplement to be used only when the others are not effective.

Q. It galantamine the same generic version of Razadyne?
   A. As far as we know, the Razadyne generic name is galantamine.

Q. I recently read about galantamine and ordered 8 mg pills. My father had Alzheimer's starting by around age 70. I have had too many senior moments so I was happy to try galantamine. The results are immediately effective but as I am only 56 years old and want to be cognizant for as long as possible, I am taking it just once every 3 or 4 days. I am afraid of building up a resistance to it and needing stronger and stronger doses. My questions are: Is taking one 8 mg tablet every 3 days as safe as taking one galantamine 4 mg tablet every day? I happened to go to another company first where I purchased 120 tablets that are 8-mg each. By safe I only mean, What is the best way for me to not build up resistance to the dosage so that i need stronger doses? Although I prefer to start with the smaller dose i hate to throw out the 120 pills i bought in order to start with 4 mg. These are capsules which can't really be cut in half. Is taking the 8 mg galantamine every 3rd day or other day as effective as taking 4 mg every day? How long is it before a person would need to increase his galantamine dose? I'm only 56 years old and want to continue for a long time. I am an active person who is not considered to be cognitively impaired. I just notice too many senior moments and i don't want to get worse. I occasionally forget i put a teapot on or forget to get something at the store. Or sometimes I walk to the other end of the house to get something and then say to myself, now what did i want to get?
   A. There is not enough long term human research with galantamine to know the safety of this substance when taken for many years or decades. The safest option is to take the least amount that works. Some people may respond to galantamine 4 mg every other day, others may prefer 8 mg every third day. There are no right or wrong answers since what works for one person may not work for another. There are many other supplements that could be useful to maintain healthy memory and mind and it may be a good idea to occasionally take a break from using a galantamine supplement and try other brain boosters. You may find the book Mind Boosters to be helpful in this regard.