The impact of galantamine on cognition and mood during electroconvulsive therapy: a pilot study.
OBJECTIVE
The purpose of this study was to: (1) assess the effectiveness of galantamine in the prevention of cognitive impairments during ECT treatment and (2) to explore the safety and tolerability of galantamine during ECT treatment.


METHODS
Nine consecutive ECT patients were given galantamine 4 mg bid throughout the course of their ECT treatments followed by a second cohort of eight consecutive ECT patients who did not receive galantamine. Objective measures of cognitive functioning and depression severity were performed pre-ECT and post-ECT. Subjective ratings of depression, confusion, and side effects were obtained weekly.


RESULTS
The two groups were similar in age, gender and admission Global Assessment Functioning (GAF) scores. There were no significant between group differences found with regards to mean seizure duration, energy administered to induce seizures, blood pressure, or heart rate during and post-ECT treatment. None of the patients discontinued galantamine due to side effects and there were no severe adverse drug reactions. Patients receiving galantamine performed significantly better on delayed memory and abstract reasoning following ECT. The galantamine group showed a greater but non-significant mood improvement (repeated measure ANOVA).


CONCLUSIONS
Our data support the hypothesis that galantamine may reduce cognitive impairment during ECT, especially with regards to new learning. In addition, galantamine may also enhance the antidepressant action of ECT. Galantamine was both safe and well tolerated during ECT.
Matthews
John D
JD
Massachusetts General Hospital, Inpatient Psychiatric Services, 55 Fruit Street, Warren 1220, Boston, MA 02114, United States. jdmatthews@partners.org
Blais
Mark
M
Park
Lawrence
L
Welch
Charles
C
Baity
Matthew
M
Murakami
Jessica
J
Sklarsky
Katherine
K
Homberger
Caitlin
C
Fava
Maurizio
M
D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D005702:Galantamine / Q000008:administration & dosage / Q000494:pharmacology*; D006323:Heart Arrest / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects; D009483:Neuropsychological Tests; D010865:Pilot Projects; D012720:Severity of Illness Index; D013390:Succinylcholine / Q000009:adverse effects
D002800:Cholinesterase Inhibitors; D009467:Neuromuscular Depolarizing Agents; D005702:Galantamine; D013390:Succinylcholine