Effects of galantamine on smoking behavior and cognitive performance in treatment-seeking smokers prior to a quit attempt

Hum Psychopharmacol. 2018 Jul;33(4):e2665. doi: 10.1002/hup.2665. Epub 2018 Jun 21.

Abstract

Objective: Drugs that enhance cholinergic transmission have demonstrated promise treating addictive disorders. Galantamine, an acetylcholinesterase inhibitor, may reduce cigarette smoking in otherwise healthy treatment-seeking smokers.

Methods: The current study is a double-blind, placebo-controlled, study that randomized daily smokers (n = 60) to receive one of two doses of galantamine extended release (8 or 16 mg/day), or a placebo treatment. Participants completed a smoking choice task as well as study measures and cognitive tasks in the laboratory and daily life using ecological momentary assessment. Analysis focused on smoking behavior and satisfaction, cognitive performance, and decision to smoke prior to a quit attempt.

Results: Linear mixed models demonstrated that, compared with placebo, both doses of galantamine reduced smoking in a laboratory choice task (p = 0.006) and decreased urine cotinine levels, but not self-reported cigarettes, during the pre-quit period (p = 0.007). Treatment had minimal effect on smoking satisfaction or cognitive performance.

Conclusions: The results suggest that galantamine reduces nicotine intake but it is unlikely that galantamine improves cognitive performance in otherwise healthy, treatment-seeking smokers. Larger randomized clinical trials can determine if galantamine adjunctive to addiction treatment can improve smoking treatment outcomes.

Keywords: cognitive performance; ecological momentary assessment; galantamine; smoking; tobacco.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cholinesterase Inhibitors / therapeutic use
  • Cognition / drug effects*
  • Cotinine / urine
  • Delayed-Action Preparations
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Galantamine / therapeutic use*
  • Humans
  • Male
  • Nootropic Agents / therapeutic use
  • Patient Acceptance of Health Care
  • Patient Satisfaction
  • Smokers / psychology
  • Smoking / drug therapy*
  • Smoking / psychology
  • Smoking / urine
  • Smoking Cessation
  • Smoking Cessation Agents / therapeutic use*
  • Tobacco Use Disorder / drug therapy*
  • Tobacco Use Disorder / psychology
  • Tobacco Use Disorder / urine
  • Treatment Outcome

Substances

  • Cholinesterase Inhibitors
  • Delayed-Action Preparations
  • Nootropic Agents
  • Smoking Cessation Agents
  • Galantamine
  • Cotinine