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Author Notes:

Dr P. Holtzheimer, III, Emory University School of Medicine, 1841 Clifton Rd NE, 4th Floor, Emory University, Atlanta, GA 30329, USA. pholtzh@emory.edu.

WMM has received grant and research support from the National Alliance for Research in Schizophrenia and Depression; American Foundation for Suicide Prevention; Fuqua Foundation; National Institute of Mental Health; National Institute of Neurological Disease and Stroke; Neuronetics, Inc.; and Janssen Pharmaceuticals, Inc. He is a consultant for Neuronetics, Inc.; Janssen Pharmaceuticals; Forest; Bristol-Meyers Squibb; Cyberonics; and Solvay Pharmaceuticals. He is on speakers bureaus for Janssen Pharmaceuticals; Forest; and Bristol-Meyers Squibb. He owns stock in Amgen; Teva; Pfizer; and Abbott. WMM assisted in the design of the study, writing and editing the final manuscript; however, he did not participate in patient recruitment, evaluation or data analysis for this study.

PEH has received grants or honoraria from the American Federation for Aging Research (AFAR); Abbott Laboratories; Cyberonics, Inc.; DANA Foundation; Neuronetics, Inc.; National Alliance for Research in Schizophrenia and Depression; National Center for Research Resources; National Institute of Mental Health; National Institutes of Health Loan Repayment Program; Stanley Medical Research Institute; Woodruff Foundation. PEH serves as a consultant for Advanced Neuromodulation Systems, Inc.

No other affiliations or disclosures are reported for any of the other authors.


Research Funding:

This work was supported in part by a grant from Janssen Pharmaceuticals (RY); the Emory Mentored Clinical Research Scholars Program (PEH; K12 RR 017643); K23 MH 077869 (PEH); and the American Federation for Aging Research (PEH).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Geriatrics & Gerontology
  • Gerontology
  • Psychiatry
  • late-life depression
  • galantamine
  • acetylcholinesterase inhibitors
  • venlafaxine
  • citalopram
  • major depression
  • antidepressant treatment
  • RISK

A double blind, placebo-controlled pilot study of galantamine augmentation of antidepressant treatment in older adults with major depression

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Journal Title:

International Journal of Geriatric Psychiatry


Volume 23, Number 6


, Pages 625-631

Type of Work:

Article | Post-print: After Peer Review


Objective: Depression in older adults is often associated with cognitive abnormalities and may predict later development of a primary cognitive disorder. This double-blind, randomized, placebo-controlled pilot study was designed to assess the safety and efficacy of galantamine augmentation of antidepressant treatment for depressive and cognitive symptoms in older adults with major depression. Methods: Thirty-eight, non-demented older adults (age >50) with major depression were randomized to receive galantamine or placebo augmentation of standard antidepressant pharmacotherapy (venlafaxine XR or citalopram). Mood and cognitive status were monitored for 24 weeks using the 24-item Hamilton Rating Scale for Depression and the Repeatable Battery for the Assessment of Neuropsychological Status. Results: Both groups showed significant improvements in mood and cognition over 24 weeks, but no significant difference was found in change over time between groups. An exploratory post-hoc analysis suggested that patients randomized to galantamine had lower depression scores compared to patients in the placebo group after 2 weeks of treatment. Dropout was high with more subjects randomized to antidepressant plus galantamine withdrawing early from the study. Conclusions: This pilot study failed to demonstrate a benefit for galantamine augmentation of antidepressant medication in the treatment of depression in older adults. Future studies should explore strategies for reducing dropout in such longitudinal trials and more carefully assess rime to response with cholinesterase inhibitor augmentation.

Copyright information:

Copyright © 2007 John Wiley & Sons, Ltd.

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