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Galantamine Uses, Side-Effects and More

Written by Matt Carland, PhD (Neuroscience) | Last updated:
Jonathan Ritter
Puya Yazdi
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology), Puya Yazdi, MD | Written by Matt Carland, PhD (Neuroscience) | Last updated:

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Diagram of galantamine

Galantamine is a medication that is FDA-approved for the treatment of Alzheimer’s disease. It has also been studied for its potential effects on oxidative stress, inflammation, and other specific medical conditions such as diabetes, obesity, and autism – although the evidence for these uses is still only preliminary. Read on to learn more about this drug, how it works, and what the current science says about some of its other potential uses!

Disclaimer: This post is not a recommendation or endorsement for galantamine. This medication is only FDA-approved for the treatment of certain specific medical disorders, and can only be taken by prescription and with oversight from a licensed medical professional. We have written this post for informational purposes only, and our goal is solely to inform people about the science behind galantamine’s potential effects, mechanisms, and uses.

What is Galantamine?

Galantamine is a nitrogen-containing compound that can be obtained synthetically, or from the bulbs and flowers of the Caucasian snowdrop (Galanthus caucasicus), Voronov’s snowdrop (Galanthus caucasicus), Galanthus woronowii, Daffodil (Narcissus) and red spider lily (Lycoris radiata ) [1, 2, 3].

Galantamine has been used for decades in Eastern Europe and Russia as a folk remedy for muscular weakness (myopathy), as well as for sensory and motor dysfunction associated with disorders of the central nervous system [4].

Galantamine is commercially available as Nivalin, Razadyne / Razadyne ER, Reminyl, and Lycoremine, and has sometimes been used in the treatment of mild cognitive impairment alone or in association with Alzheimer’s disease [5, 6, 7, 8].

Official Medical Uses of Galantamine

1) Treating Alzheimer’s Disease

Galantamine is an effective treatment for Alzheimer’s disease, and has been officially approved by the FDA for this medical use.

Many Alzheimer’s patients report benefitting from galantamine therapy that is initiated early, soon after diagnosis, and continued for at least 1 year [8].

Galantamine is believed to act by increasing the concentration and overall activity of acetylcholine in the brain, which has been preposed to account for its effects on the symptoms of Alzheimer’s disease [9, 10].

A key sign of Alzheimer’s disease is a decrease in hippocampal episodic memory function due to the build-up of β-amyloid plaques which cause a breakdown of cholinergic signaling. Galantamine is believed to be a useful treatment for Alzheimer’s due to its ability to increase hippocampal function via improving cholinergic neurotransmitter function [11, 12].

Some evidence suggests that galantamine may help limit the cognitive decline associated with Alzheimer’s disease. For example, one study reported that this effect may persist for up to 36 months after beginning galantamine treatment, suggesting that there may be some significant long-term potential for galantamine use in this medical condition [13].

In fact, long-term galantamine treatment has been reported to delay an individual’s placement in a nursing home, suggesting improved overall functioning and quality-of-life [13].

Although the precise mechanisms behind it aren’t fully known yet, some studies have concluded that long-term treatment with galantamine may effectively increase the connections between neurons in the brains of Alzheimer’s patients. By extension, it has been proposed that these neuronal connections may help stabilize cognitive performance in these patients [14].

Galantamine may also have some effects on build-up of beta-amyloid plaques in brain cells, which is believed to be the main factor responsible for causing Alzheimer’s disease. For example, one animal study reported that galantamine reduced the amount of beta-amyloid plaques in the brains of mice with Alzheimer’s disease, as well as decreased the activity of astrocytes (a type of cell in the nervous system that forms “scars” in areas where neurons have been damaged) [15].

According to some preliminary studies, galantamine has also been reported to have some “antidepressant”-like effects, and may have even improved sleep quality in dementia patients [16, 17]. This may suggest some mood- and sleep-related effects, although more research will be needed to know for sure.

Galantamine has been reported to be just as effective as donepezil, a cognition-enhancing medication commonly used to treat Alzheimer’s disease [18].

However, galantamine has been proposed to be far more cost-effective than conventional Alzheimer’s treatment with typical cholinesterase inhibitors, which may give it a slight advantage when it comes to medical use [19].

Other Potential Effects & Uses of Galantamine

In addition to its FDA-approved medical use in Alzheimer’s disease, galantamine has also been studied for its potential effects on a number of other health-related functions and conditions.

However, much of this research is still in a relatively early stage, and in most cases it is difficult to come to any firm conclusions about its relative efficacy and safety in healthy human users.

Therefore, the potential effects listed below are still considered to have “insufficient evidence”, and should be taken with a grain of salt until further research work – including large-scale clinical trials in healthy human users – is performed.

INSUFFICIENT EVIDENCE:

1) May Help Treat Mild Cognitive Impairment (MCI)

Mild cognitive impairment (MCI) is a condition that involves a gradual loss of cognitive function over time. MCI sufferers often complain of memory failure. One study administered galantamine (4 mg twice per day) to sufferers of MCI for 7 days. These patients were reported to show a subsequent improvement in performance on memory tasks (episodic face-encoding and working memory tasks) [11].

Another similar study reported that patients with MCI showed evidence of improved episodic memory and reduced reaction times when treated with galantamine [20].

Cholinergic malfunction is believed to be responsible for some of the memory impairments commonly seen in MCI subjects. This shared mechanism may be why galantamine (an acetylcholinesterase (AChE) inhibitor and modulator of nicotinic acetylcholine receptors) has been reported to be effective at improving brain function [11].

Some early evidence also suggests that galantamine may help promote brain growth – possibly via activation of the M1 muscarinic and α7 nicotinic acetylcholine receptors [21].

Additionally, according to one animal study In mice, galantamine (at 0.3-3mg/kg) was reported to increase brain IGF-2 levels, which may explain its ability to increase the growth of new brain cells [22].

However, it should be noted that much of the research regarding galantamine and degenerative brain disorders have been done on rodents. One study showed that primates (our closer relatives) show the same cognitive benefits, but milder ones [23]. Therefore, it’s an open question whether- and to what extent similar effects may be seen in human patients, and more clinical trials will be needed to fully confirm these preliminary animal findings.

2) May Reduce Inflammation

According to some early reports, galantamine may help decrease brain inflammation [24].

Although the exact mechanisms responsible for this potential effect are not yet known, some preliminary evidence suggests that galantamine may exert anti-inflammatory effects by modifying NF-κB, TNF-α, visfatin & adiponectin [24].

Galantamine has also been reported to activate the cholinergic anti-inflammatory pathway, one of the fundamental anti-inflammatory pathways in human biology, which protects the body from prolonged exposure to systemic inflammation. This pathway is activated by through α7 nicotinic acetylcholine receptors (α7 nAChR), which therefore may account for some of galantamine’s reported anti-inflammatory effects [25, 26, 27].

In fact, some early data suggests that activating the cholinergic anti-inflammatory pathway (in such a way as Galantamine does) may potentially reduce the production of pro-inflammatory cytokines by an impressive 50-75% [25] – although more research will definitely be needed to confirm this further.

Relatedly, one animal study reported that galantamine suppressed systemic inflammation in mice by decreasing the breakdown of acetylcholine (specifically, via inhibition of acetylcholinesterase, or AChE) [28].

3) May Act as an Antioxidant

Oxidative stress can cause a lot of health issues in the human body, and has been reported to be especially relevant to a number of significant health conditions such as Alzheimer’s, Parkinson’s, Huntington’s, Down’s syndrome, cancer, and diabetes [29].

Some early evidence suggests that galantamine may act as an antioxidant, and could therefore potentially protect cells from oxidative stress [29].

Additionally, some preliminary findings suggest that galantamine may help protect the brain from cellular damage due to reactive oxygen species (ROS) – specifically, by activating NRF2 and protecting mitochondria [29].

Nonetheless, more research in human populations will be needed to determine the full scope of this potential effect, as well as to narrow down what the exact mechanisms might be.

4) May Protect Against Toxins

Findings from some early animal studies suggests that galantamine may have some noteworthy anti-toxic effects – although this will still have to be followed up on and confirmed by studies in human subjects.

For example, one animal study reported that galantamine protected against the effects of toxic poisoning (with diisopropylfluorophosphate) in rats [30].

Galantamine was also reported to protect rats from endotoxins in the blood (specifically, by lowing levels of pro-inflammatory cytokines as well as reducing MPO activity) [31].

5) May Treat Diabetes

Some early evidence suggests that galantamine may have anti-diabetic effects by improving insulin signaling pathways (specifically by acting on p-insulin, p-Akt, GLUT4, and GLUT2 receptors) [26, 24].

According to one animal study, galantamine was reported to counteract high levels of blood sugar, reduce immune cell activity in the pancreas, and decrease the production of anti-insulin antibodies in mice with type-1 diabetes [32].

However, these findings have only been reported in animal studies, and appropriate human studies will be needed to confirm them.

6) May Treat Obesity

Two animal studies reported that when Galantamine was administered to mice with high fat diet-induced obesity, it significantly lowered inflammation, body weight, insulin resistance and cholesterol levels [33].

While promising, this finding will have to be followed up on with studies in humans before any solid conclusions can be made about galantamine’s potential effects on obesity or body-weight regulation in general.

7) May Induce Lucid Dreaming

A lucid dream is a dream in which an individual is aware that they are dreaming, and often has some control over their dreams.

Some researchers have suggested that galantamine may enhance lucidity in dreams by altering the cholinergic system and increasing the levels of acetylcholine in the brain [34].

However, this interesting effect could come with significant downsides. For example, the increases in acetylcholine and other cholinergic mechanisms could cause impairments in overall sleep quality – specifically, by increasing the amount of time spent in the REM stage of sleep [35].

8) May Alleviate Symptoms of Autism

Some early evidence from studies in children with autism suggests that galantamine may have some potential use in treating or managing some of the symptoms of this disorder.

For example, one study reported that administering galantamine alongside risperidone (an antipsychotic medication) to autistic children led to improvements in several common symptoms of autism, such as irritability, lethargy, and general social withdrawal [36]. However, it’s unclear how much of this effect was due specifically to galantamine, risperidone, or the specific combination of the two – and more studies will be needed to fully determine this.

Relatedly, one other preliminary study reported that stimulation of the central nervous system’s (CNS) serotonergic subsystem (a major neurotransmitter system that is believed to play a central role in regulating mood and various cognitive functions) by using galantamine may enhance expressive language and communication in autistic adults [37].

While some of these early results are promising, many more large-scale clinical trials will be needed to study the therapeutic potential of galantamine therapy in autistic patients [37].

9) May Help Treat Schizophrenia

According to one preliminary study, galantamine may potentially counteract the damaging effects of kynurenic acid, increased levels of which have been associated with some of the common cognitive problems characteristic of schizophrenia [38].

Another early study reported that galantamine may affect the AMPA-mediated signaling pathway, which in theory could protect the brain and improve memory in schizophrenics [39]. However, much more research on this effect and its potential mechanisms will still be needed to know for sure.

10) May Relieve Arthritis Symptoms

According to one animal study, galantamine was reported to suppress arthritic inflammation in rats with low testosterone. The appearance of dopamine in the spleen during Galantamine treatment was interpreted by the study’s authors as a marker of its protective action under androgen-deficient conditions (most people over 40 are probably androgen-deficient) [40].

However, this has only been reported by a single animal study, so much more research will be needed to follow up on this possible effect in human users.

11) May Aid In Quitting Smoking

According to one interesting preliminary study, alcoholics who took galantamine on a daily basis reported smoking on fewer days, and consumed significantly fewer total cigarettes compared to similar patients who only took a placebo. Even without taking other initiatives or intentions to reduce smoking, smoking behavior was reduced [41].

However, since this study was done specifically in human alcoholics, more research on non-alcoholic populations would be needed to see if galantamine has any similar effects in smokers in general.

12) May Protect Against Brain Trauma

Electroconvulsive therapy (ECT) is an effective treatment for psychotic patients who have not responded to conventional therapy or medications – but it can cause cognitive impairment as an unfortunate side-effect [42].

However, one early study has reported that Galantamine supplementation may help protect against a loss in learning abilities if given both during- and after treatment with ECT [42].

Some preliminary evidence suggests similar potential effects in other forms of brain damage as well. For example, rats injected with Galantamine prior to having an artificially induced stroke (low oxygen levels in the brain for 2 hours) were reported to have less extensive brain damage than rats that were not given galantamine. The galantamine-treated rats also reportedly had lower levels of pro-inflammatory IL-1B and microglial accumulation, suggesting a possible mechanism for these purported “protective” effects [43].

Similarly, according to one study in patients with post-traumatic palsy, galantamine accelerated the resolution of post-traumatic eye problems [44].

Overall, though, the evidence is still very weak, and a lot more research will be needed to see what effects – if any – galantamine might have on protecting the physical health of the brain, and what specific conditions this effect might apply to in human patients.

Side-Effects

Given that galantamine has met FDA approval for medical use (in Alzheimer’s disease), the majority of scientific evidence supports the overall safety and effectiveness of galantamine when used as prescribed, and under the supervision of qualified medical professionals.

Nonetheless, like any drug, there is always at least some potential of experiencing adverse side-effects, and so it’s important to be aware of these. If you experience any of the following symptoms occur while being treated with galantamine, contact your doctor immediately.

Some commonly-reported side-effects of galantamine include muscle cramps and weakness, cardio-respiratory events, skin problems, and urinary incontinence. Taking high doses of Galantamine without building up slowly may also cause nightmares and anxiety [45].

In addition to these effects, galantamine’s interaction with other drugs may cause health problems. It is advised to limit the usage of galantamine when taking certain other medications that are metabolized via the same liver pathway (the hepatic cytochrome system) [46].

Fortunately, most of the above side-effects are rare and can probably be avoided with sensible dosing. Therefore, discussing your treatment with your doctor – and using this medication only exactly as prescribed – is probably sufficient to minimize your risk of experiencing adverse side-effects.

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About the Author

Matt Carland

Matt Carland

PhD (Neuroscience)
Matt received his PhD at the Université de Montréal in Neuroscience.
Matt holds multiple degrees in psychology, cognitive science, and neuroscience. He has over a decade of experience in academic research and has published a number of articles in scholarly journals. He currently works as a neuropsychologist in Montreal, where he performs research on the links between personality traits and the development of clinical disorders such as addiction, compulsive gambling, and disordered eating.

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