GALANTHAMINE IN ALZHEIMERS-DISEASE - A NEW ALTERNATIVE TO TACRINE

Galanthamine (galantamine), a tertiary alkaloid derived from the bulbs of the snowdrop and various Narcissus species, is a selective, centra lly active and reversible inhibitor of acetylcholinesterase that is su itable for oral therapy. After a long period during which the investig ational and clinical use of the drug was limited to anaesthesia and th e treatment of peripheral paralysis syndromes in Eastern Europe, the m olecule has now emerged as a promising lead substance for the treatmen t of cognitive decline in Alzheimer's disease. Galanthamine has simila r therapeutic potential to tacrine, but has a significantly more favou rable pharmacokinetic and toxicity profile. A chemical synthesis proce ss on the required industrial scale of several tons per year has becom e available, removing a major obstacle to the development of the drug. Clinical trials published so far are, however, rather limited in term s of both design and patient number. The main reason for this is that there has been a lack of strong support for the drug within the pharma ceutical industry. However, the available data support the notion that this molecule, if properly developed, could be a peer for any second- generation cholinergic drug currently in clinical trials for the sympt omatic treatment of Alzheimer's disease.