Narcissus and Daffodil

414 J.R. Murray
cognitive function (Davis, 1987). A later patent was taken out by the same author
for the same indication and routes of administration, but covering new derivatives
of galanthamine or their analogues (Davis and Joullie, 1988).
Patients with Down’s Syndrome (trisomy of chromosome 21) can develop
histological changes resembling those seen in the brains of Alzheimer’s patients.
Learning ability in patients with Down’s Syndrome may be improved by galanthamine
(Fransits and Mucke, 1997).
One prolific investigator from Iceland has taken out a series of patents addressing
the treatment of mania (Snorrason, 1994), fatigue syndromes (Snorrason,
1992a), various forms of arthritis (Snorrason and Murray, 1997), attention deficit
disorders (Murray and Snorrason, 1999a) and proteolytic diseases (Murray and
Snorrason, 1999b), as well as methods for countering the side-effects of benzodiazepine
therapy (Snorrason, 1992b,c). Acute mania is a difficult condition to treat
and often requires high doses of neuroleptics given for a number of days. The
author claims galanthamine to be a faster treatment than other drugs. Stress is
placed within the patent on the activity of galanthamine at nicotinic receptors.
Fatigue is a common enough symptom in primary care medicine, but its clinical
importance cannot be over-estimated. It can be a major aspect of significant morbidity.
Fatigue associated with viral infections, especially the Epstein Barr virus,
can be prolonged and debilitating. Mononucleosis in late-teens or the University
years can result in long periods of marked fatigue leading to considerable impairment
of performance. In its severe form – myalgic encephalitis (ME) or Chronic
Fatigue Syndrome (CFS) – patients experience debilitating fatigue lasting for
more than 50% of the day over a period of six months or more. Such patients are
usually in the ‘bread-winning’ years of life and may be unable to work for several
years and can even be dependent upon a wheelchair. No effective treatment presently
exists for this condition. Galanthamine is claimed as a treatment for fatigue,
muscle pains and sleep disturbances in CFS. Claims are made for galanthamine, or
its derivatives, to be effective in the treatment of various fatigue syndromes,
including those associated with HIV infections and pre-eclampsia.
Cholinesterases also have proteolytic enzyme activity. Two patents from the
Icelandic author, working with a British colleague, address the potential for galanthamine
to have a positive effect on disease conditions in which proteolytic
enzymes appear to play an important role. The first addresses the role of raised
proteolytic enzyme and cholinesterase activity in the synovial fluid in the joints of
patients with rheumatoid arthritis. Claims are made for galanthamine in the treatment
of rheumatoid and osteo-arthritis, arthritis associated with auto-immune
disease, psoriasis, chronic inflammatory bowel disease, ankylosing spondylitis, as
well as a range of other joint disorders. Such treatment, if successful, could be
expected to be disease-modifying rather than simply palliative. The second patent
addresses head-on the concept that proteolytic activity in other diseases is associated
with acetyl cholinesterase activity, and that this could be blocked or inhibited
by treatment with galanthamine, epigalanthamine or norgalanthamine. Such diseases
would include psoriasis, Crohn’s Disease and ulcerative colitis.
Attention deficits and hyperactivity disorders (ADHD) are thought to affect 5%
of children in the USA and Europe. Moreover, such behavioural problems can be
carried into adult life where they may manifest themselves as alcohol or drug
abuse and other anti-social behavioural traits. Current therapy in childhood