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Galantamine (Razadyne) is FDA-approved only for treatment of Alzheimer disease (AD), but a previous trial also suggested some efficacy in patients with vascular dementia (Journal Watch May 10 2002). In a new trial, 788 patients with probable vascular dementia were randomized to a 26-week course of galantamine or placebo. The primary endpoint was improvement on both a standardized cognitive scale and an activities-of-daily-living (ADL) scale. At 26 weeks, galantamine was associated with a statistically significant mean benefit of 1.5 points on the 70-point cognitive scale, but ADL scores did not differ between groups.
Donepezil (Aricept) is now FDA-approved for both mild-to-moderate and severe AD. In another trial, 343 patients with severe AD…