Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Galantamine is an oral medication used to treat patients with Alzheimer's disease. Galantamine is in a class of drugs called cholinesterase inhibitors that also includes tacrine (Cognex), donezepil (Aricept), and rivastigmine (Exelon). Cholinesterase inhibitors inhibit (block) the action of acetylcholinesterase, the enzyme responsible for the destruction of acetylcholine. Acetylcholine is one of several neurotransmitters in the brain, chemicals that nerve cells use to communicate with one another. Reduced levels of acetylcholine in the brain are believed to be responsible for some of the symptoms of Alzheimer's disease. By blocking the enzyme that destroys acetylcholine, galantamine increases the concentration of acetylcholine in the brain, and this increase is believed to be responsible for the improvement in thinking seen with galantamine. Galantamine was approved by the FDA in 2001.
(The brand name of galantamine was changed in 2005 from Reminyl to Razadyne.)
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 4, 8,
and 12 mg . Extended release capsules: 8, 16, and 24 mg. Oral solution: 4 mg/mL.
STORAGE: Tablets and liquid solution should be stored at room temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Galantamine is used for the treatment of mild to moderate dementia of the Alzheimer's type.
DOSING: Galantamine usually
is taken twice daily, preferably with the morning and evening meals. Most often, galantamine therapy is started with the lowest dose, 4 mg twice daily, for several weeks, and then continued at 8 mg twice daily for a further several week period. Thereafter, some patients may need a higher dose. Extended release capsules are taken once daily.
DRUG INTERACTIONS: Drugs with anticholinergic properties and which cross into the brain, such as atropine,
benztropine (Cogentin), and trihexyphenidyl (Artane) produce opposite effects of (counteract) galantamine and should be avoided during therapy with galantamine.
Unlike donepezil (Aricept), galantamine does not increase blood levels of other medications and increase their risk for side effects.
PREGNANCY: Studies in pregnant rats and rabbits using galantamine at high doses failed to show effects on the offspring; however, no studies have been performed in
pregnant women. Therefore, physicians must weigh the potential benefits against the potential risks of galantamine before prescribing it for pregnant women.
NURSING MOTHERS: It is not known if galantamine is secreted in
breast milk.
SIDE EFFECTS: The most frequent side effects seen with galantamine are
nausea (one in six treated persons),
vomiting (up to one in ten persons), diarrhea (up to one in
eight persons), anorexia (loss of appetite), and weight loss. These side effects
generally occur during the beginning of treatment or when the dose is increased.
These side effects typically are mild and temporary. Taking galantamine with food and ensuring adequate fluid intake may reduce the impact of these side effects. Fewer than one in ten persons will need to stop treatment due to side effects. In one two-year study, 1.3% of patients receiving galantamine died compared to 0.1% of patients receiving placebo. Half of the deaths were due to vascular disease (heart attack, stroke) or sudden death which are expected in an elderly population.
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
Mental health is more than just being free of a mental illness. It is more
of an optimal level of thinking, feeling, and relating to others.
Mentally healthy individuals tend to have better medical health,
productivity, and social relationships.
Mental illness refers to all of the diagnosable mental disorders and is
characterized by abnormalities in thinking, feelings, or behaviors.
Some of the most common types of mental illness include anxiety,
depressive, behavioral, and substance-abuse disorders.
There is no single cause for mental illness. Rather, it is the result of a
complex group of genetic, psychological, and environmental factors.
While everyone experiences sadness, anxiety, irritability, and moodiness at
times, moods, thoughts, behaviors, or use of substances that interfere with a
person's ability to function well physically, socially, at work, school, o...
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