Meta-analysis of randomized controlled trials of galantamine in schizophrenia: significant cognitive enhancement

source extracted confidence: high 2026-04-09
#cognition #cognitive-dysfunction #drug-therapy-combination #galantamine #humans

Meta-analysis of randomized controlled trials of galantamine in schizophrenia: significant cognitive enhancement

Koola et al., 2020 | Psychiatry Res | Meta Analysis

Citation

Koola Maju Mathew, Looney Stephen W, ... Hou Wei. Meta-analysis of randomized controlled trials of galantamine in schizophrenia: significant cognitive enhancement. Psychiatry Res. 2020-Sep;291:113285. doi:10.1016/j.psychres.2020.113285

Abstract

Cognitive impairments are core features of schizophrenia and the best predictor of functional outcome. Cholinergic system and alpha-7 nicotinic acetylcholine (α7nACh) receptors are strongly implicated in the pathophysiologic mechanisms associated with cognitive impairments in schizophrenia. Galantamine is not only a reversible, competitive inhibitor of acetylcholinesterase but also a type I positive allosteric modulator of α7nACh receptors. The objective of this meta-analysis was to examine the efficacy of galantamine for cognitive symptoms of schizophrenia. In the meta-analysis that included six randomized controlled trials (RCTs, N=226), cognitive impairments significantly improved with galantamine compared to placebo, with a small Hedges' g effect size of 0.233. This finding is consistent with other RCTs in schizophrenia with medications with a similar mechanism of action. On the basis of the results from all the failed (although some efficacy has been shown) RCTs to date in schizophrenia, targeting only one pathophysiologic mechanism may be insufficient to detect a clinically meaningful signal. Nicotinergic medications, like any other add-on medications, are unlikely to be effective as stand-alone medications. Hence, these medications may have to be combined with other medications with complementary mechanisms such as glutamatergic/N-methyl-D-aspartate systems to detect a meaningful effect size for the three domains of psychopathology.

Key Findings

Hence, these medications may have to be combined with other medications with complementary mechanisms such as glutamatergic/N-methyl-D-aspartate systems to detect a meaningful effect size for the three domains of psychopathology.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 226
Age Range See abstract
Condition cognitive

MeSH Terms

  • Cognition
  • Cognitive Dysfunction
  • Drug Therapy, Combination
  • Galantamine
  • Humans
  • Nootropic Agents
  • Randomized Controlled Trials as Topic
  • Schizophrenia
  • Schizophrenic Psychology

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis
  • Vertical: niacin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09