Galantamine: a review of its use in Alzheimer's disease and vascular dementia.

Dementia has the potential to become a major public health concern during this century due to increasing life expectancy and growth in the ageing population. The commonest types of dementia include Alzheimer's disease (AD), vascular dementia (VaD), and dementia with cerebrovascular components. Galantamine is the only acetylcholinesterase inhibitor that exhibits a dual mechanism of action--inhibition of acetylcholinesterase and nicotinic receptor modulation. Clinical studies demonstrate the efficacy and safety of galantamine in patients with AD, VaD, and AD with cerebrovascular components. Galantamine shows beneficial effects on cognition, global function, activities of daily living and behaviour. Adverse events observed with galantamine use are generally mild to moderate in severity, transient and gastrointestinal in nature. The dose of galantamine should be escalated to 16 and 24 mg/day at four-week intervals to achieve maximal tolerability. Because of its unique mechanism of action, galantamine may have potential benefits over conventional enzyme-inhibiting agents.