Galantamine for Dementia

Q. Dear Dr. Dean,

My 89 year old mother has been taking galantamine for almost 3 years for vascular dementia. She is now up to 16 mg/day. However, it does not seem to be helping like it did at first. I am concerned about increasing the dosage because she is so sensitive to all drugs/supplements. If we stop the galantamine, should it be done gradually or can it just be stopped?

Thank you for your help,

LINDA, Aurora, OH

A. Dear Linda,

If your mother previously did well on galantamine, you might try increasing the dose by another 4 mg per day, to see if it restores her previous benefit. It may be that her requirements have increased over the past three years, or her receptors have become somewhat resistant.

Please see the answer above, regarding the rare adverse effect of nightmares and anxiety due to excessive doses of galantamine. Doses of up to 24 mg per day have been shown to be of benefit without adverse effects. However, if adverse effects are experienced at any dose, galantamine can be discontinued without ill effect.

Ward Dean, M.D.

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