title: Galantamine: a cholinergic patch in the treatment of alcoholism: a randomized, placebo-controlled trial.
abstract: OBJECTIVE
  The involvement of the central cholinergic system in alcohol abuse behavior is well known. It is possible that the reinforcing effects of ethanol are partially mediated by nicotinic receptors, which modulate neurotransmitter release. It was demonstrated that the application of a cholinesterase inhibitor reduces alcohol consumption in alcohol-preferring rats. This suggests that galantamine (GAL), a cholinesterase inhibitor, could be effective when seeking to prolong abstinence in recently detoxified alcoholics. This study represents the first reported clinical trial of a cholinergic drug in alcohol-relapse prevention.
  
  
  METHODS
  We investigated the efficacy and safety of GAL by conducting a 24-week randomized, placebo-controlled, multicentric clinical trial on 149 recently detoxified alcoholics. Survival analyses (Kaplan-Meier) were performed to reveal evidence of prolonged abstinence periods in patients who received GAL.
  
  
  RESULTS
  Our findings did not support our hypothesis. GAL did not extend the time to first severe relapse. However, additional post hoc analyses suggest that relapsed patients treated with GAL consume less ethanol per drinking day than patients treated with placebo.
  
  
  CONCLUSIONS
  GAL seems to be ineffective when used in relapse prevention of detoxified alcoholics. It is possible that alcohol needs to be "on board" for GAL to be beneficial. This could explain why our post hoc analysis showed that GAL possibly reduces the alcohol consumption of relapsers. If confirmed, GAL could play a role in the reduction of harmful alcohol use and at-risk consumption.
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, J 5, 68159 Mannheim, Germany. sucht@zi-mannheim.de
authors.forename: K
authors.initials: K
authors.lastname: Mann
authors.forename: K
authors.initials: K
authors.lastname: Ackermann
authors.forename: A
authors.initials: A
authors.lastname: Diehl
authors.forename: D
authors.initials: D
authors.lastname: Ebert
authors.forename: G
authors.initials: G
authors.lastname: Mundle
authors.forename: H
authors.initials: H
authors.lastname: Nakovics
authors.forename: T
authors.initials: T
authors.lastname: Reker
authors.forename: G
authors.initials: G
authors.lastname: Richter
authors.forename: L G
authors.initials: LG
authors.lastname: Schmidt
authors.forename: M
authors.initials: M
authors.lastname: Driessen
authors.forename: K
authors.initials: K
authors.lastname: Rettig
authors.forename: K
authors.initials: K
authors.lastname: Opitz
authors.forename: B
authors.initials: B
authors.lastname: Croissant
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000437:Alcoholism / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005702:Galantamine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male
chemical_list: D002800:Cholinesterase Inhibitors; D005702:Galantamine