Treating dementia – the leading disease burden of the future

Galantamine hydrobromide (reminyl) is an ace-inhibitor used to treat mild to moderate dementia in Alzheimer’s disease. It works in two ways, by inhibition of the enzyme anticholinesterase and by acting on acetylcholine on the nicotinic receptors.

Galantamine hydrobromide has a prolonged release formulation available in 8, 16 and 24 mg strengths. In clinical trials it has been shown to be effective when used in doses of 16 to 24 mg/day. 8 mg/day is the starting dose that is currently recommended, this dose is then doubled after 4 weeks to 16 mg/day. Finally the dose can be increased to 24 mg/day after 4 weeks at 16 mg/day.³

Virtual Medical Centre conducted the survey to the right. Of all respondents, 83% said the dose they most commonly prescribe is 8 mg (the initiation dose). This research indicates that some doctors may not be aware of the recommended use for the 16 and 24 mg doses. Results also suggested that galantamine hydrobromide was commonly prescribed in younger (55-65 years) compared to older (65 plus) patients, even though the risk for Alzheimer’s disease increases with age, with more than 14% of over 65 year olds having the disease.²

An economics report published by Alzheimer’s Australia estimated that based on current figures, by 2016, dementia will be the leading cause of disease burden in Australia.¹ In response to this, Virtual Medical Centre have an online education program (sponsored by Janssen-Cilag) designed to raise awareness of dementia in general practice. ‘Reminisce – A GP Program on Dementia’ is currently freely accessible to members of the Virtual Medical Centre. This program allows GPs to recognise the characteristics of dementia, understand its prevalence and under-diagnosis, enhance their diagnostic capabilities and improve management strategies.

To access the Reminisce program, please click here.

References:

1. Access Economics. The dementia epidemic: economic impact and positive solutions for Australia. Canberra: Access Economics, March 2003. Available at: http://www.alzheimers.org.au/upload/Dementia Ful Report May 2003 (2)l.pdf (accessed June 2007).
2. Hebert LE, Scherr PA, Beckett LA. Age-specific incidence of Alzheimer’s disease in a community population. JAMA 1995; 273: 1354.
3. ‘Reminyl Prescribing information’ [online], MIMS, 2006, Available at URL: http://www.mims.com.au (last accessed 25/01/2007)