Posted by Chairman_MAO on October 26, 2005, at 11:32:52
In reply to morphine and tacrine » Chairman_MAO, posted by Declan on October 26, 2005, at 1:01:06
The Bulgarians I refer to are SoPharma, a premier eastern european pharma mfg. IIRC, Bulgaria was where most of the former USSR's pharma development took place.
Check out www.nivalin.com for a great review of its mechanism of action.
AChEs in overdose conditions:
1: Klin Med (Mosk). 1996;74(8):58-61.
[Aminostigmine-a novel drug against home poisoning]
[Article in Russian]
Bonitenko II, Safronov GA, Sosiukin AE, Pershin VN, Shpilenia LS.
Miltary Medical Academy, Saint-Petersburg.
Aminostigmin, a novel reversible inhibitor of cholinesterase developed in
Russia, has been tried in management of poisoning with cholinolytyics,
antihistamine drugs, tricycle antidepressants and derivatives of
1,4-benzodiazepine. The treatment of 144 patients with aminostigmin and 20
patients with galantamin showed close to similar efficacy of these drugs. The
scheme of aminostigmin administration is proposed warranting fast relief of
cholinolytic syndrome in subjects poisoned with cholinolytics, antihistamine
drugs and antidepressants. Benzodiazepines poisoning was unresponsive to
aminostigmin. Rare side effects were caused by overdose. Aminostigmin is an
effective antidote in cholinolytic poisoning.1: Anaesthesia. 1974 Sep;29(5):581-4.
Treatment of respiratory depression with the anticholinesterase drug
galanthamine hydrobromide.Cozanitis DA, Toivakka E.
Galantamine in other novel applications:
1: Clin Neuropharmacol. 2002 Sep-Oct;25(5):272-5.
Adjuvant galantamine administration improves negative symptoms in a patient with
treatment-refractory schizophrenia.Rosse RB, Deutsch SI.
Mental Health Service Line, Department of Veterans Affairs Medical Center,
Washington, DC 20422, USA.Because of the demonstration of a selective alpha nicotinic receptor abnormality
in patients with schizophrenia, galantamine was added to the stable regimen of
atypical and other antipsychotic medications in a 43-year-old man manifesting
severe and persistent positive and negative symptoms, as well as mood
disturbance and cognitive dysfunction. Galantamine is an inhibitor of
acetylcholinesterase and a positive allosteric modulator of nicotinic
cholinergic receptors (with a FDA-approved indication for the treatment of
patients with mild to moderate Alzheimer disease (AD) under the trade name
Reminyl). Galantamine HBr was initiated at a dose of 4 mg po BID, which was
maintained for the first week of adjuvant therapy, and eventually was increased
to 12 mg po BID during the final weeks of his 2-month trial. Remarkably, within
1 week of its initiation, there was a dramatic and clinically significant
decrease of negative symptoms, as reflected in formal ratings on the Scale for
the Assessment of Negative Symptoms. Moreover, within a few days of galantamine
discontinuation, negative symptoms worsened, returning to the baseline level of
severity. In addition to targeting memory dysfunction in AD,
acetylcholinesterase inhibitors may have an expanded range of targets and
clinical indications, including behavioral and psychotic symptoms. Galantamine
is distinguished from other acetylcholinesterase inhibitors by its positive
allosteric modulatory properties, improving the efficiency of transduction of
the acetylcholine signal at nicotinic receptors. This latter property may have
contributed to the observed improvement in negative symptoms observed in this
patient. Importantly, positive symptoms were unchanged during this 2-month
trial.(7)Hence my idea of using benzos (5-20mg/day) for positive symptoms and concomitant galantamine (4-24mg/day) for negative symptoms. A touch of a neuroleptic, lithium, etc would probably even out any residual symptoms. VERY toleable treatment considering the benzo and AchE inhibitor will balance out each others untoward effects to a significant degree.
poster:Chairman_MAO
thread:569687
URL: http://www.dr-bob.org/babble/20051024/msgs/572083.html