Update on Alzheimer drugs (galantamine).

BACKGROUND Deficient cholinergic function contributes to the cognitive and behavioral signs and symptoms of Alzheimer disease (AD). A successful treatment approach in AD has been the enhancement of cholinergic function by cholinesterase inhibitors. REVIEW SUMMARY Galantamine is a cholinesterase inhibitor and allosteric modulating ligand at nicotinic cholinergic receptors. Galantamine 24 mg/d has been demonstrated consistently effective compared with placebo for the cognitive, functional, and behavioral aspects of Alzheimer's disease in large multicenter trials. Cognition and function on average are preserved for 12 months in Alzheimer disease patients receiving galantamine. It is safe and very well tolerated when dosage is escalated gradually. CONCLUSIONS Galantamine is a valuable addition to agents available for the pharmacologic treatment of AD.