Anyone tried Galantamine for Vagus Stimulation?

[energyoverload]

Has anyone tried the drug galantamine to stimulate function of the Vagus Nerve. It acts as a cholinesterase inhibitor and also nAChR7 agonist. The latter may provide protection against inflammation in rodent sepsis models. It could certainly slow the heart some, as a side effect can be bradycardia so this may benefit POTS/OI.

 

[energyoverload]

Wow no one yet!

 

[sillysocks84]

I haven't heard of it yet. I'm also really new to this disease and forum. I hope someone else will post their insight on this. Sounds like an exciting possibility anyways, after everything that has been tried hopefully something could be of help

 

[sillysocks84]

Psychiatry Investig. 2009 Sep;6(3):204-10. doi: 10.4306/pi.2009.6.3.204. Epub 2009 Jun 23.
The effects of galantamine hydrobromide treatment on dehydroepiandrosterone sulfate and cortisol levels in patients with chronic fatigue syndrome.
Turan T1, Izgi HB, Ozsoy S, Tanrıverdi F, Basturk M, Asdemir A, Beşirli A, Esel E, Sofuoglu S.
Author information

Abstract
OBJECTIVE:
Mental fatigue, cognitive disorders, and sleep disturbances seen in chronic fatigue syndrome (CFS) may be attributed to cholinergic deficit. A functional deficiency of cholinergic neurotransmission may cause the hypothalamic-pituitary-adrenal axis hypoactivity seen in CFS. Therefore, we investigated the alterations in stress hormones such as cortisol and dehydroepiandrosterone sulfate (DHEAS) in CFS patients before and after 4-week administration of galantamine hydrobromide, a selective acetylcholinesterase inhibitor, and aimed to investigate whether there are any relationships between the probable hormonal changes and cholinergic treatment.

METHODS:
Basal levels of cortisol and DHEAS were measured in 29 untreated CFS patients who were diagnosed according to Centers for Disease Control (CDC) criteria and in 20 healthy controls. In the patient group, four weeks after 8 mg/d galantamine hydrobromide treatment, cortisol and DHEAS levels were measured again. After the treatment 22 patients who stayed in study were divided into two subgroups as responders and nonresponders according to the reduction in their Newcastle Research Group ME/CFS Score Card (NRG) scores.

RESULTS:
Important findings of this study are lower pre-and post-treatment cortisol levels and in all CFS patients compared to controls (F=4.129, p=0.049; F=4.803, p=0.035, respectively); higher basal DHEAS values and higher DHEAS/cortisol molar ratios which were normalized following four weeks' treatment with 8 mg/d galantamine hydrobromide in the treatment-respondent group (F=5.382, p=0.029; F=5.722, p=0.025, respectively).

CONCLUSION:
The findings of the decrease in basal DHEAS levels and DHEAS/cortisol molar ratios normalizing with galantamine treatment may give some support to the cholinergic deficit hypothesis in CFS.

KEYWORDS:
Chronic fatigue syndrome; Cortisol; Dehydroepiandrosterone sulfate; Galantamine hydrobromide

 

[sillysocks84]

@energyoverload I find the above study intriguing because my DHEA is low. This article seems to indicate that galantamine treatment may normalize the DHEA levels. Also low levels of DHEA can cause aching joints, fatigue, muscle weakness and low sex drive.

 

[energyoverload]

Also interesting is Galantamine agonises nAChR7 which has demonstrated anti-inflammatory effects in rodent models of sepsis, and is believed to stimulate the Vagus nerve - which may be one mechanism by which it can reduce production of pro-inflammatory cytokines.

Sine groups have found chemical stimulation of vagus nerve can exhibit similar results to that of Electrical vagus nerve stimulators on vagal tone, cytokine response etc.

nAChR7 agonism is a potential target for sepsis attenuation also.

 

[sillysocks84]

@energyoverload is galantamine easily obtainable? Have you tried this yet?

 

[helen1]

@energyoverload
If you do a google site search you'll see where galantamine has been discussed in other threads. I noticed that nanuog has tried it; perhaps others.

 

[Eve18]

Hi, I am new here.
I started gelantamine 8mg/d today. No side effectes so far.
I'll try to post in few weeks to let you know how it works for me.

I have CFS, POTS (bad one, not only standing, sometimes sitting makes me sick with 140 heartbeats). After having abnormal results on a ACTH stimulation test and many other different symptoms I belive my HPA axis doesn't work well.

 

[sillysocks84]

@energyoverload can you link some articles?

@Ewa please do let us know how it works out. Has it effected your heart rate yet or too early to tell?

 

[Eve18]

For last few days my heart rate wasn't really bad so it's hard to say. But mostly I didn't stand, I rested most of the time.
The doctor told me that if it works for me I should see a difference in about 2 weeks.
I'll let you know.

 

[energyoverload]

@ Ewa thanks! let us know how it goes for you! I was in touch with the manufacturer of transcutaneous VNS stimulator NEMOS (ww.nemos.uk.com). They have a good deal on at the moment to try device for 6 months for a total of £400, so if it doesn't work you don't have to buy it at a cost of aroung £2500. In the email through unfortunately I don't think we could get this offer if a physician prescribed off-label. The enclosed PDF disclaimer has offer only for current approved indication - epilepsy

 

[SDSue]

Hi, I am new here.
I started gelantamine 8mg/d today. No side effectes so far.
I'll try to post in few weeks to let you know how it works for me.

I have CFS, POTS (bad one, not only standing, sometimes sitting makes me sick with 140 heartbeats). After having abnormal results on a ACTH stimulation test and many other different symptoms I belive my HPA axis doesn't work well.

Watching thread. Hoping good things for you!

 

[Eve18]

After first week:
I wear Fitbit all the time, last few days my resting heart rate goes down, every day few beats less per min., I still avoid standing but for last few days my max. heart rate was about 120. Used to be 140 one week ago.
I was hoping for less brain fog, more clarity in thinking. Still not good but for last three days I was able to focus and read one chapter of a book per day.
It can be coincidence of course, you know how POTS can be different from day to day.
I don't have any side effects, always taking gelantamine with food. I'll take it for few more weeks for sure.

 

[sillysocks84]

That is great news so far @Ewa. I'm focusing on the positives and hoping continuing progress for you! Keep updating please Also, what is fitbit?

 

[sillysocks84]

@Ewa how has the galantamine treatment been going? I hope you haven't been on here because you are doing well!

 

[halcyon]

Here's an older study I randomly came across:

Trial of a Selective Acetylcholinesterase Inhibitor, Galanthamine Hydrobromide, in the Treatment of Chronic Fatigue Syndrome

1996, Vol. 2, No. 2-3 , Pages 35-54
Ernir Snorrason, Arni Geirsson, and Kari Stefansson
Department of Psychiatry, University Hospital, Reykjavik, 105, Iceland,
Department of Internal Medicine, University Hospital, Reykjavik, Iceland,
Division of Neuropathology, Department of Neurology, Boston Beth Israel Hospital, Harvard Medical School, Boston, MA, 02115,

The purpose of the study was to search for a means of diminishing the plight of patients with chronic fatigue syndrome (CFS) and to test the hypothesis that central to the pathogenesis of CFS is a cholinergic defect. Forty-nine patients who fulfilled consensus criteria for CFS were treated with the acetylcholinesterase inhibitor, galanthamine hydrobromide. Thirty-nine patients finished the study according to the protocol with 43% reporting 50% improvement in fatigue, myalgia and sleep and 70% reporting 30% improvement whereas patients in the placebo group reported only 10% improvement in the same parameters of CFS. The improvement of patients on galanthamine was in most cases gradual and reached significance for the group only after four to eight weeks. The improvement was stable, and no patients who reported over 50% improvement on galanthamine relapsed to a pretrial level of any symptom. One of the most surprising effects was the dramatic improvement of sleep disturbances that occurred in most patients on this medication: more than 60% of the patients who finished the study reported over 70% improvement in sleep deficit. If the subjective report by patients can be proved by objective means, this would be the first demonstration of a drug that can be used to correct a sleep disturbance that also influences a specific stage in normal sleep. The most common adverse effect of galanthamine, as given in this study, was nausea that was dose-dependent and reversible. Galanthamine hydrobromide is relatively safe and appears to be an effective medication against many symptoms of CFS. But the positive results of this study have to be interpreted cautiously because of methodological limitations of this trial. First, this study was originally organized as a double-blind, placebo-controlled trial but was changed to an optional crossover after two weeks of treatment. Also, the adverse effects of the active drug in 30% of patients could compromise the double-blind. With these limitations in mind, it is nevertheless tempting to conclude that this study lends an indirect support to our hypothesis that a cholinergic deficit may play a role in the pathogenesis of the syndrome.

 

[sillysocks84]

@halcyon thanks for finding and sharing! Although once again it kind of goes to show how various areas in this disease seems to just drop off with no explanation. It is just so frustrating! Sometimes I feel we will find a cure ourselves before they do at this rate.

 

[halcyon]

Another trial mentioned in the AHRQ review on treatment. This one found no benefit over placebo:

JAMA. 2004 Sep 8;292(10):1195-204.
Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial.
Blacker CV1, Greenwood DT, Wesnes KA, Wilson R, Woodward C, Howe I, Ali T.
Author information

Abstract
CONTEXT:
There is no established pharmacological treatment for the core symptoms of chronic fatigue syndrome (CFS). Galantamine hydrobromide, an acetyl cholesterone inhibitor, has pharmacological properties that might benefit patients with CFS.

OBJECTIVE:
To compare the efficacy and tolerability of galantamine hydrobromide in patients with CFS.

DESIGN, SETTING, AND PATIENTS:
Randomized, double-blind trial conducted June 1997 through July 1999 at 35 outpatient centers in the United Kingdom (n = 17), United States (n = 14), the Netherlands (n = 2), Sweden (n = 1), and Belgium (n = 1) involving 434 patients with a clinical diagnosis of CFS (modified US Centers for Disease Control and Prevention criteria).

INTERVENTIONS:
A total of 89 patients were randomly assigned to receive 2.5 mg of galantamine hydrobromide; 86 patients, 5.0 mg; 91 patients, 7.5 mg; and 86 patients, 10 mg (these patients received medicine in the tablet form 3 times per day); a total of 82 patients received matching placebo tablets 3 times per day.

MAIN OUTCOME MEASURES:
The primary efficacy variable was the global change on the Clinician Global Impression Scale after 4, 8, 12, and 16 weeks of treatment. Secondary outcomes were changes in core symptoms of CFS on the Chalder Fatigue Rating Scale, the Fibromyalgia Impact Questionnaire, and the Pittsburgh Sleep Quality Index; changes in quality of life on the Nottingham Health Profile; and assessment of plasma-free cortisol levels and cognitive performance on a computer-based battery of tests.

RESULTS:
After 16 weeks, there were no statistically significant differences between any of the galantamine or placebo groups in clinical condition on the Clinician Global Impression Scale, or for any of the secondary end points. Exploratory regression analysis failed to detect any consistent prognostic factor that might have influenced the primary or any secondary outcome measures.

CONCLUSION:
This trial did not demonstrate any benefit of galantamine over placebo in the treatment of patients with CFS.

 

[sillysocks84]

Well maybe @Ewa improved, she hasn't been on since June. Anyone have anything to add about galantamine?