A 12-week, Double-Blind, Placebo-Controlled Trial of Galantamine Adjunctive Treatment to Conventional Antipsychotics for Cognitive Impairments in Chronic Schizophrenia

To study the effects of acetylcholinesterase inhibitors on cognition of patients with schizophrenia, we investigated the impact of galantamine administration on the cognitive impairments in patients with chronic schizophrenia. A 12-week, double-blind, placebo-controlled trial of galantamine as adjunctive treatment to conventional antipsychotic drugs was conducted in 24 patients with schizophrenia. Subjects had been stabilized on conventional antipsychotic drugs (chlorpromazine equivalent dose 1,390 mg/day) for a minimum of 3 months. The subjects were evaluated at baseline, and after 6 and 12 weeks using the Korean version of the Mini Mental State Examination (K-MMSE), Brief Psychiatric Rating Scale (BPRS), and a standard neuropsychological battery. Compared to placebo, galantamine produced only a small and non-significant improvement on cognitive measures. However, the score for recognition on the Rey Complex Figure Test (RCFT) was significantly improved in patients given galantamine(p<0.05). Of the several domains of cognitive functions assessed, galantamine tended to improve the score for recognition on the Hopkins Verbal Learning Test (HVLT) and for color on the Stroop Tests (p<0.1). The K-MMSE scores did not change significantly in patients given galantamine and the changes of the psychiatric symptoms were not significant. Galantamine was relatively well tolerated. Addition of galantamine to patients with schizophrenia did not dramatically improve measures of cognition or psychopathology. Further studies that include larger sample sizes are required to investigate the role of galantamine as a cognitive enhancer in schizophrenia.