Buyer beware: Nine out of 10 over-the-counter galantamine supplement brands tested contained way less of the drug than they advertised — and several were contaminated with harmful bacteria.
Want to boost your memory? Or control your dreams? It costs $50 to buy 90 pills of galantamine, a brain-boosting nootropic supplement that promises to enhance cognition and stimulate lucid dreaming, making you aware of and in control of your dreams. According to the label, anyway. But buyers may get more — or less — or worse — than they bargained for.
Independent researchers have zeroed in on brain-boosting supplements in the past to test their quality. Studies have shown that some of the supplements were found to contain illegal and unlabeled ingredients, way too much or way too little of the ingredients listed on the label, and to boot, there isn’t much evidence that they work as advertised.
But over-the-counter galantamine brain boosting supplements are a little different from many other nootropics in one fundamental way: There is also a regulated, FDA-approved drug version of galantamine prescribed by neurologists to treat the symptoms of mild to moderate Alzheimer’s disease.
A study published in JAMA compared the quality of 11 generic, FDA-approved galantamine drugs to 10 brands of over-the-counter galantamine supplements with labels that claimed to contain similar doses of galantamine.
While the generic drugs passed all the quality checks, almost all the supplements — nine out of the 10 tested — contained less of the drug than advertised, and three products were contaminated with bacteria.
“Ninety percent, or nine out of the 10 brands, had an inaccurate amount of galantamine on the label,” Dr. Pieter Cohen, lead author and neurologist at Cambridge Health Alliance, told Being Patient. “Disturbingly, 30 percent — three out of 10 brands — were also contaminated with bacteria that could, if consumed at higher levels, cause diarrheal illnesses,” he added.
“Our study raises a troubling question: Are the laws regulating dietary supplements in the U.S. adequate to ensure the quality of the many active drugs sold directly to U.S. consumers as supplements?” Cohen said. “We think not.”
Cohen explained that it’s a problem that people can access over-the-counter supplements that have the same dose of galantamine as actual drugs. Those products should only be sold as FDA-approved drugs,” he added.
What did the researchers find?
The study analyzed the quality of 11 brands of generic galantamine drugs, which require a prescription, and compared them to 10 brands of galantamine supplements available online or over-the-counter.
Cohen and his team examined whether the amount of galantamine listed on the label was accurate and whether there was any contamination in the product. The generic drugs passed these tests, while many supplements did not.
One product claimed that its capsules contained 6 mg of galantamine, but the researchers found less than 0.1 mg in each capsule — 60 times less than advertised. Another brand claimed their capsules had 8 mg of the supplement, but the researchers only measured less than 1/14 of that — 0.56 mg — in their product.
Only one of the ten brands of supplements that the researchers looked at accurately labeled their galantamine content. They also did not find any contaminants in that one product. At the request of the journal, the published study didn’t specify the names of the brands it tested.
(According to Cohen, the journal asked the authors to remove the brand names. In the past researchers have faced lawsuits from litigious supplement manufacturers after publishing quality control studies. In 2015, when his research showed that they contained an illegal drug called BMPEA — a form of amphetamine — Cohen was sued by a supplement company called Hi-Tech Pharmaceuticals sued Cohen for $50 million in compensatory damages as well as $150 million for slander and libel for publishing his research and then publicizing it in news outlets. He eventually won the case.)
How popular are galantamine supplements?
There aren’t a lot of studies looking at how many people are using the supplement form of galantamine. The drug version is covered by 97 percent of Medicare plans, according to GoodRx. People with Medicare may need a co-pay of up to $10. This means that most people prescribed galantamine will likely be able to afford it and won’t necessarily need to consider over-the-counter options.
What is galantamine used for?
Many people on forums that discuss lucid dreaming and nootropic supplements frequently bring up galantamine supplements. Depending on the brand of supplement that recreational users are purchasing, they might be getting what is essentially a sugar pill or a substantially lower dose than they bought and might also receive a contaminated product.
The three brands that mentioned dream recall or lucid dreaming had substantially less galantamine — between 98.4 and 38 percent less — than advertised on the label.
Can galantamine make you sick?
Yes, it is possible galantamine will make you sick. Galantamine itself can cause some unpleasant side effects like nausea, vomiting, or diarrhea. As for galantamine in over-the-counter supplements with inaccurate quantities and potential contamination: If the amount in the supplement is much less than the label claims, this is a case for bacteria being the culprit in making people sick.
The study sourced the supplements from Amazon U.S.
On one brand of galantamine supplement — from supplement maker DreamTech — a handful of Amazon reviewers (six out of 1,500) did note diarrhea, stomach problems, or other symptoms between January 2017 and January 2022.
“This drug made my fiance very sick, he lost work over a three-day period and is still trying to recover,” one reviewer wrote of DreamTech’s galantamine supplement. “I bought these to just help get vivid dreams as I don’t dream at night and just get blackness. Started with 4mg the first night. Did 8mg, then 12mg. Nothing. Just gave me diarrhea,” wrote another. (It’s impossible to know what other factors may have impacted the health of these reviewers at the time they were trying DreamTech’s galantamine supplements.)
Where can you get safe galantamine?
According to Cohen, the only way to ensure galantamine isn’t contaminated and contains the right dosage is to get it via a prescription from a doctor.
Until the FDA changes the laws around supplement marketing and sales and begins regulating this “Wild West” of an industry, this will remain the case.
As a licensed pharmacist for over sixty years with a relative with Alzheimer’s I find it frustrating when I cannot tell which Rx or Oct drugs might help my loved one. And how do I know if the Rx drugs I have dispensed have the drug strength noted on the label and don’t have the bad bacteria we have seen in the otc Serine.
We in medicine are like a pilot flying with blinders
Barry, we understand your frustration. Thanks for reading. We’ll be keeping you posted on all the latest news on prescription and OTC drugs.