Galantamine may help to Improve Episodic Memory

Galantamine Hydrobromide TabletsGood for Remembering the Events of Your Life

What we now know is that galantamine is good for enhancing episodic memory, as per a recent study.1 Episodic memory is the memory of the events that comprise your autobiography (places, times, associated emotions, along with other contextual familiarity) that can be clearly stated. Together with semantic memory, episodic memory makes up the declarative memory category (aka explicit memory), which is one of the two major divisions in memory. The counterpart is procedural memory, or implicit memory.2

Back to the study. Evidence continues to compile that cognitive impairment is quite common in those with bipolar disorder, even when they have not experienced major depression or mania for some time and are generally characterized as possessing a reasonably positive mood. Among the common cognitive impairments are acute mood episodes, along with deficits in executive functioning, attention, visual-spatial abilities, memory, and verbal fluency. Even in the remissive form (called euthymia), impairment of executive functioning, verbal learning, motor coordination, and visual-spatial tasks occur.

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Galantamine as a Cognitive Enhancing Agent

Could the administration of galantamine improve cognition in such patients, those with minimally symptomatic bipolar disorder? That was the question taken up by the researchers, led by Philip D. Harvey, PhD, Professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine. Dr. Harvey is the author of over 700 scientific articles and abstracts. In addition he has written over 30 book chapters and given more than 1,300 presentations at scientific conferences and medical education events. He has edited 5 books and written 4 books on topics of psychological assessment, schizophrenia, and aging. Among his many areas of interest is cognition and the use of cognitive enhancing agents for a variety of conditions. In the study at hand, the researchers assessed the effect of galantamine on clinical measures of functioning and psychopathology.

†In the interest of full disclosure, 5 of the paper’s 9 authors have received either grants, honoraria, and/or are consultants to pharmaceutical companies, including the manufacturer of pharmaceutical galantamine. Dr. Dunn currently is employed by Pfizer Inc. and Dr. Harvey currently receives a research grant from Bristol-Myers Squibb, while a consultant for Johnson & Johnson, Dainippon Sumitomo, Pfizer, and Neurogen and serves as a lecturer for Eli Lilly.

Galantamine is Unique in its Class

Galantamine is a novel cognitive-enhancing agent approved for the treatment of Alzheimer’s disease. It is also a natural nutritional supplement sold for supporting healthy memory function. Mechanistically, galantamine works in two way: First, it inhibits acetylcholinesterase (an enzyme that prematurely breaks down the memory molecule acetylcholine, aka ACh). Second, galantamine also protects and preserves a type of cellular ACh receptor called the nicotinic acetylcholine receptor, thereby effectively increasing the activity of ACh. The two effects (of which the second is the more important) tend to protect and preserve memory and other cognitive functions against the ravages of Alzheimer’s disease, which is characterized by impaired cholinergic and nicotinic functions, which are linked to cognitive deterioration. This is the rationale for the therapeutic effect of galantamine, which by the way is unique in its class of drugs or supplements. Interestingly, similar cognitive dysfunction may be related to bipolar disorder, and thus the rationale for the study.

Galantamine may be able to
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Galantamine may be beneficial as a preventive, able to help maintain normal cognitive functions. The use of galantamine for bipolar disorder has been suggested by early case reports as do small randomized clinical trials in schizophrenia, where improvement on episodic memory has been noted. Nevertheless, the Harvey et al. study is the first randomized clinical trial to explore the impact of galantamine on cognition in bipolar disorder. For good reason, the principal hypothesis held that galantamine would be effective for some aspects of cognitive functioning in minimally symptomatic bipolar disorder.

Using a randomized double-blind, placebo-controlled, parallel 30 patients (aged 18 to 60 years) were first confirmed with a diagnosis for bipolar disorder (type I or II) and then administered either galantamine or placebo and followed over the course of 3 months. The dose of galantamine in a time-release form was administered at 8 mg/d during the first month, 16 mg/d for the second month, and then 24 mg/d for the third month. Given the pharmacodynamics of galantamine, the differences between the time-release form and the immediate-release form are moot.3 However, in the real world, the difference is one of compliance; once a day is easier than twice or three times.

Galantamine for Verbal Learning and Episodic Memory

There were 16 subjects who completed baseline and follow-up neuropsychological testing for evaluation (10 with galantamine and 6 with placebo). Those subjects receiving galantamine showed improved performance on a verbal learning test, while the placebo group showed improvement on another test measuring trail-making conditions and category fluency. However, episodic memory performance improved in the galantamine treatment group but did not improve in the placebo group. In contrast, performance on two of the processing speed measures showed significant improvement in the placebo condition, whereas that of the patients treated with galantamine did not improve.

Of interest, improvements in cognitive function over baseline appeared within 1 week of reaching a galantamine dosage of 24 mg/d. Thus the mean dose for subjects receiving galantamine was just under 20 mg/d. Galantamine may thus have specific benefits for episodic memory, but not processing speed, in patients with cognitive impairment as part of bipolar disorder.

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References

  1. Ghaemi SN, Gilmer WS, Dunn RT, Hanlon RE, Kemp DE, Bauer AD, Chriki L, Filkowski MM, Harvey PD. A double-blind, placebo-controlled pilot study of galantamine to improve cognitive dysfunction in minimally symptomatic bipolar disorder. J Clin Psychopharmacol 2009 Jun;29(3):291-5.
  2. Tulving, E. Precis of elements of episodic memory. Behav Brain Sci 1984;7:223–68.
  3. Robinson DM, Plosker GL. Galantamine extended release. CNS Drugs 2006;20(8):673-81; discussion 682-3.
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Galantamine may help to Improve Episodic Memory – Taj Dearob Pharma | What we now know is that galantamine is good for enhancing episodic memory, as per a recent study.1 Episodic memory is the memory of the events that comprise your autobiography (places, times, associated emotions, along with other contextual familiarity) that can be clearly stated.
Galantamine may help to Improve Episodic Memory – Taj Dearob Pharma | What we now know is that galantamine is good for enhancing episodic memory, as per a recent study.1 Episodic memory is the memory of the events that comprise your autobiography (places, times, associated emotions, along with other contextual familiarity) that can be clearly stated.
Galantamine may help to Improve Episodic Memory – Taj Dearob Pharma | What we now know is that galantamine is good for enhancing episodic memory, as per a recent study.1 Episodic memory is the memory of the events that comprise your autobiography (places, times, associated emotions, along with other contextual familiarity) that can be clearly stated.