We know that supplementing with acetylcholine precursors (choline, phosphatidylcholine, CDP-choline), cholinergic agonists (DMAE, centrophenoxine) and cholinesterase-inhibitors (huperzine A) can stem age-related cognitive decline and provide significant support to those suffering mild or moderate forms of Alzheimer’s disease. These precursors are perfectly complemented by galantamine, an alkaloid found naturally in snowdrops (Galanthus nivalis) and other species of the same family.
• The snowdrop has been used medicinally since antiquity - it is actually mentioned in the Iliad. Homer describes how Odysseus, King of Ithaca, was poisoned by Circe at a banquet, probably with an extract of datura, a powerful anticholinergic. The god Hermes recommends snowdrop as an antidote!
• Galantamine was isolated in 1956 by a team of Bulgarian scientists and was soon being used in neurological and neuromuscular applications. These days, it is widely employed as a treatment for those suffering from mild or moderate Alzheimer’s disease.
• Two large clinical studies have reported notable improvements in memory and learning in Alzheimer’s patients. These studies also showed improved ADAS-cog scores (Alzheimer’s Disease Assessment Scale - Cognition) in galantamine-supplemented subjects while the scores of those taking a placebo dropped. Scientists thus observed that galantamine supplementation was associated with significant and rapid improvements, or stabilisation, in cognition and behaviour.
• A randomised, double-blind, placebo-controlled clinical trial enrolled 643 patients suffering from mild to moderate Alzheimer’s disease, with 80% of patients completing the trial. Over a period of six months, they were given daily doses of 24-32mg of galantamine, after which the doses were gradually increased for the following four weeks. Results demonstrated that galantamine was well-tolerated and effective in treating Alzheimer’s disease. It slowed the decline in cognitive and functional capacity.
• A meta-analysis of seven studies has also confirmed galantamine’s efficacy in treating mild to moderate Alzheimer’s disease. It underlined important benefits in studies lasting three, five and six months. Galantamine was shown to be effective in overall cognitive tests, and evaluation of everyday activities and well-being. The most common doses used in these studies were 24 or 32mg/day. However the authors concluded that a dose of 16mg was sufficient, with the same efficacy as higher doses but with less potential for side-effects.
How does galantamine work?
• First and foremost, galantamine inhibits acetylcholinesterase (like huperzine A) which destroys synaptic acetylcholine, an essential neurotransmitter for intracellular communication in the brain, which is necessary for memory, attention and concentration mechanisms... Levels of acetylcholine tend to decline with age and its activity is significantly reduced in those with Alzheimer’s or other forms of senile dementia.
• Supplementing with galantamine thus increases levels of acetylcholine, stimulates its action on acetylcholine receptors in the brain and also improves cerebral blood flow, enhancing cognitive performance and reducing the risk of stroke from elevated blood pressure. Indeed, vascular dementia and Alzheimer’s disease are often seen together. The underlying cause of vascular dementia is often the existence of cerebrovascular disease where furring of the arteries disrupts blood flow. This predisposes to elevated blood pressure and increases vulnerability to stroke. In one study, 592 patients aged between 40 and 90 with diagnosed cerebrovascular disease, accompanied by probable vascular dementia or Alzheimer’s disease, were divided into two groups – one was given a placebo, the other 4mg of galantamine a day, the dose increasing by an additional 4mg/day at one-week intervals so that by week six, they were taking 24mg/day. After six months’ treatment, cognition had improved, not only in relation to the control group but also compared with these patients’ own scores six months previously. Functional autonomy was also greater and behavioural problems had lessened. The improvements in these subjects’ condition were comparable to those observed in earlier galantamine studies on Alzheimer's patients.
• In addition, galantamine modulates – like tobacco - specific receptors in the brain, alpha-7 nicotinic receptors. Stimulation of these receptors, which are abundant in those areas of the brain which Alzheimer’s attacks, improves learning, memory, attention and concentration. By maintaining their numbers and functional integrity, galantamine thus reduces severity of Alzheimer’s disease and also produces the effects conferred by nicotine but without having to suffer the ills of smoking!
Cognitive and behavioural improvement and/or stabilisation
• With its nootropic properties, galantamine effectively increases acetylcholine levels, thus increasing memory, attention, concentration and learning. It may even improve sensory perception of colours, making them clearer and brighter.
• Galantamine also improves sleep quality, helping to achieve a sounder sleep: you fall asleep faster and wake up feeling invigorated. A little like melatonin, which is known to facilitate dreaming, galantamine aids ‘lucid’ dreaming in which you are aware of your dreams, making them easier to remember; the increase in acetylcholine levels undoubtedly contributes significantly to this as it is known to increase the length of REM sleep.
• Galantamine is therefore a very important nootropic which eases cognitive problems and increases intellectual ability. For more than 20 years, it has aroused a great deal of interest across the world and is specified in the United States for Alzheimer’s patients – it is actually authorised for such use by the FDA.
In general, galantamine is well-tolerated at 8mg a day split into two doses because its half-life is approximately six hours.
There are few reported side-effects from prolonged use. The only such references in the scientific literature are linked to plant allergies to narcissi, manifesting as nausea, dizziness and urticaria, in all cases of a limited and reversible nature.
adults. Take 2 vegetarian capsules a day.
Each capsule contains 4mg of galantamine.