Galantamine in the treatment of adult autism: a report of three clinical cases.
OBJECTIVE
To study the usefulness of galantamine, a competitive, reversible acetylcholinesterase inhibitor (AChEI), in adults diagnosed with autism (in accordance with DSM-IV-TR Axis I clinical criteria) before age three years.


METHODS
To promote verbalization and meaningful speech sound production through biochemical enhancement of the serotonergic subsystem of the central nervous system (CNS), galantamine 4 mg qhs was administered, with indicated dose increases.


RESULTS
Verbal fluency increased in all patients, according to their caregivers. One patient developed a macular rash that abated when the medication was discontinued. After one month on donepezil 5 mg qhs, verbal and behavioral regression again led to discontinuation. Doses for the other patients have been escalated by 4 mg daily each month to a maximum of 12 mg, with improvement following each increase.


CONCLUSIONS
Cholinergic stimulation of the CNS serotonergic subsystem with galantamine may enhance expressive language and communication in autistic adults. Clinical trials are needed to study adjuvant therapy with galantamine in such patients.
Hertzman
Marc
M
hertzman@attglobal.net
D000328:Adult; D001321:Autistic Disorder / Q000188:drug therapy* / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005702:Galantamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000187:drug effects
D002800:Cholinesterase Inhibitors; D005702:Galantamine