Summary: Galantamine, a medication used to treat Alzheimer’s disease, shows promise in helping break opioid addiction.
Clinical trial results reveal that a medication used to treat Alzheimer’s disease may also be an effective therapy for individuals addicted to opioids. The findings are published in The American Journal on Addictions.
The medication, called galantamine, is thought to have a dual mechanism of action–it increases levels of a chemical messenger called acetylcholine in the brain and also binds to nicotinic receptors, which play a role in addiction to nicotine and other substances.
Participants who took galantamine had fewer urine samples that were positive for opioids compared with those who took placebo, which corroborated with self-reported abstinence in those who took galantamine. Also, participants who used opioids during follow-up took longer to do so if they were in the galantamine group.
“My colleagues and I are excited about these preliminary findings, as they could point to new strategies for helping those with opioid use disorder. We hope to pursue this in future research,” said lead author Kathleen Carroll, PhD, of the Yale University School of Medicine.
Penny Smith – Wiley
The image is in the public domain.
Original Research: Closed access
“Double‐Blind Placebo‐Controlled Trial of Galantamine for Methadone‐Maintained Individuals With Cocaine Use Disorder: Secondary Analysis of Effects on Illicit Opioid Use”. Kathleen M. Carroll PhD, Elise E. DeVito PhD, Sarah W. Yip PhD, Charla Nich MS, Mehmet Sofuoglu MD, PhD.
American Journal on Addictions. doi:10.1111/ajad.12904
Double‐Blind Placebo‐Controlled Trial of Galantamine for Methadone‐Maintained Individuals With Cocaine Use Disorder: Secondary Analysis of Effects on Illicit Opioid Use
Background and Objectives
Concurrent use of cocaine and opioids is a persistent and challenging problem, particularly within methadone maintenance settings, and there are no approved pharmacotherapies for this population. Galantamine, a cholinesterase inhibitor, was found in a randomized clinical trial to reduce cocaine use among methadone‐maintained individuals who were also cocaine dependent. Because of the potential of galantamine to reduce multiple drugs of abuse, it may also reduce opioid use.
We conducted a secondary analysis of a randomized, double‐blind, placebo‐controlled trial of 120 methadone‐maintained individuals with concurrent cocaine dependence. Participants were randomized to galantamine or placebo in a 12‐week trial with a 6‐month follow‐up (97% of intention to treat sample reached for final follow‐up).
There was a significant main effect for galantamine over placebo on percent of urine specimens that were negative for opioids, both within treatment (77% for galantamine vs 62% for placebo, F = 5.0, P = 0.027) and through a 6‐month follow‐up (81% vs 59%, respectively, F = 10.8, P = 0.001). This effect was seen regardless of whether participants used nonprescribed opioids during the baseline period. Galantamine effects were seen early in treatment, with participants in placebo submitting the first opioid‐positive urine specimen significantly sooner than participants in galantamine (median day 15 vs 53, Wilcoxon = 5.7, P = 0.02).
Conclusions and Scientific Significance
If these results are supported in future trials, galantamine may hold promise across multiple drugs of abuse, including opioids.