Historical note and terminology
Cholinesterase inhibitors remain the dominant approach concerning the symptomatic treatment of Alzheimer disease. In 1993, tacrine was the first cholinesterase inhibitor approved by the Food and Drug Administration for use in Alzheimer disease. Following tacrine was the approval of donepezil in 1996 and rivastigmine in 2000. Galantamine (also called galanthamine in some studies) hydrobromide was approved in 2001 by the FDA. A solution preparation is also available for patients who either cannot swallow tablets or prefer liquid medications.
Galantamine was discovered accidentally in the 1950s by a Bulgarian pharmacologist in the bulbs and flowers of wild Caucasian snow drops, Galanthus woronowii (Sramek et al 2000). Initially, it was used as an agent to reverse the effect of curare in anesthetic practice.
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