Switching from Donepezil to Galantamine

Q After reading many of the articles you have written on the subject of galantamine, which impressed me very much, I have recently placed an order for two bottles of a galantamine supplement. My wife suffers from Alzheimer’s, perhaps in the moderate stage. She has been taking Aricept (donepezil) at a level of 10 mg since her condition was diagnosed about three years ago.

Last month, a new drug was approved and commercialized in France and most of Europe called Ebixa (memantine), but it has not yet been approved by the FDA. She continues to take Aricept, and now two tablets of Ebixa per day, with no apparent side effects. It is claimed that this new product may slow down Alzheimer’s considerably. After a month of taking this new drug, it’s hard to observe any great changes in her being.

However, I have been encouraged by your comments concerning galantamine, and we are anxiously looking forward to seeing how it may affect my wife’s condition. I have one question to ask your opinion on, namely, if my wife starts taking the suggested daily amounts, would it have any effect if she continued taking Aricept and Ebixa as mentioned above?

Speaking with a professor on the subject here in Nice, he said he thought it best to stop taking Aricept if she started taking a galantamine product, but to continue with the latest drug, Ebixa. He is under the impression that Reminyl is the same as a product containing galantamine, choline and vitamin B5, I think; hence he didn’t think it necessary to take Aricept as well. I realize that this supplement is not the same as Reminyl, which I gather contains only galantamine.

I would welcome an opinion on this subject and any other comments you may have to make. I understand you cannot give medical advice but presume you have great faith in your product and can give me an objective opinion.

Lawrence, Nice, France

A Although there is no research showing additional benefits from taking galantamine along with donepezil, there have been a number of papers published showing the benefits of moving from donepezil to galantamine, and there appears to be no liability in doing so.

We have every reason to believe that a product containing choline and vitamin B5, the precursor and cofactor, respectively, for the endogenous (internal) manufacture of acetylcholine, is probably better than one containing just galantamine. Regarding the NMDA antagonist memantine, because its mechanism is different than galantamine’s—it is also a dopamine releaser—it may be useful as an adjunctive therapy.1

  1. Reisberg B, Doody R, Stoffler A, Schmitt F, Ferris S, Mobius HJ. Memantine in moderate-to-severe Alzheimer’s disease. N Engl J Med 2003 Apr 3;348(14): 1333-41.

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