DONEPEZIL for the treatment of mild to moderate Dementia

(Doe nep’ e zil)

Donepezil is an oral medication used for the treatment of mild to moderate dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality) in people who have Alzheimer’s disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities).

Donepezil Image

Donepezil belongs to a class of drugs called cholinesterase inhibitors. It improves mental function (such as memory, attention, the ability to interact with others, speak, think clearly and perform regular daily activities) by reversibly inhibiting acetylcholinesterase an enzyme responsible for the destruction of the neurotransmitter, acetylcholine. This leads to increased concentrations of the naturally occurring substance acetylcholine in the brain, and the increased concentrations are believed to be responsible for the improvement seen during treatment with Donepezil, by increasing the amount of a certain naturally occurring substances in the brain. Donepezil may improve the ability to think and remember or slow the loss of these abilities in people who have Alzheimer’s.

How this medication should be used:

Donepezil is an oral drug and hence must be taken by mouth, it comes usually as film coated tablets provided in strengths of 2mg, 4mg, 8mg, 16mg and 32mg. It has a recommended dose of 5mg once a day initially and increased if necessary after one month to a maximum dose of 10mg daily. It can be taken with or without food around the same time every day and try as much as possible to swallow the tablets whole without crushing or chewing.

It is important to be aware that Donepezil is not a cure for Alzheimer’s so do not attempt increasing your dose without first informing your prescriber. Also make sure your prescriber is fully aware of your medical history such as other medications you may be on, any known allergies, any other illnesses which may include glaucoma, irritable bowel disease, motion sickness, myasthenia gravis, Parkinson’s disease, ulcers, or urinary problems.

There are no special dietary requirements to be followed, just maintain a healthy balanced diet except told otherwise by your prescriber.

If you forget to take a dose of Donepezil, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you do not take Donepezil for 1 week or longer, you should call your prescriber before starting to take this medication again.

Taj Accura Pharmaceuticals provide Donepezil in 5mg and 10mg film coated tablets. For more information please contact Taj Accura Pharmaceuticals in Dublin on 01 2931882 or email info@tajaccura.com

 

SIDE EFFECTS

Adverse effects of acetylcholinesterase inhibitors such as Donepezil notably include nausea, vomiting, anorexia, diarrhoea, fatigue, and dizziness. Other common adverse effects include abdominal pain, dyspepsia, rash, pruritus, headache, somnolence, muscle cramps, insomnia, sweating, tremor, and syncope; upper-respiratory-tract and urinary-tract infections have been noted. Rare cases of angina, sino-atrial and AV blocks, bradycardia, peptic ulcers, gastrointestinal haemorrhage, extrapyramidal symptoms, and seizures have been observed. Psychiatric disturbances, including depression, hallucinations, agitation, aggressive behaviour, and confusion have also been reported. There is a potential for bladder outflow obstruction. Minor increases in serum-creatine kinase have also occurred with Donepezil.

Increased liver transaminases have been noted with acetylcholinesterase inhibitors; hepatotoxicity may be severe with the acetylcholinesterase inhibitor tacrine

The use of acetylcholinesterase inhibitors has been associated with weight loss and consequently some licensed product information has recommended that a patient’s weight is monitored during treatment. Female patients have been found to be more susceptible to nausea, vomiting, anorexia, and weight loss.

Over dosage with cholinesterase inhibitors may result in ‘cholinergic crisis’.

 

RECENT CASE STUDY ON DONEPEZIL

Parallel Improvement of Cognitive Functions and P300 Latency Following Donepezil Treatment in Patients with Alzheimer’s Disease: A Case–Control Study

Chang, Yu-San*; Chen, Hsiang-Lan; Hsu, Chung-Yao††; Tang, Shu-Hui; Liu, Ching-Kuan††

Purpose: To evaluate the effect of Donepezil, one of the cholinesterase inhibitors, on P300 measurements in patients with Alzheimer’s disease (AD) and investigate the relationship between the sub factors of cognitive performance and P300 components.

Methods: One hundred outpatients with AD were evaluated for cognitive function (cognitive ability screening instrument) and event-related potentials before and after 22 to 23 weeks of treatment with donepezil (5 mg/day). Twenty age-matched normal control subjects were recruited.

Results: The patients with AD showed prolonged P300 and N200 latency, no significant differences in N100 and P200 components, and poor performance in neuropsychological assessments compared with control subjects at baseline. After Donepezil treatment, the patients with AD had reduction in P300 latency at Pz lead, which was associated with a parallel improvement in cognitive function in terms of remote memory, recent memory, visual instruction, and orientation. The pre–post treatment difference of P300 latency significantly correlated with the cognitive ability screening instrument score difference and recent memory score difference, respectively.

Conclusions: The patients with AD still had intact early sensory processing but impaired higher-level cognitive processes that could influence behaviour deviation. The Donepezil treatment, which enhances higher-level cognitive processing time, revealed that P300 latency decreases as cognitive capability increases, especially improved in recent memory.

FUN FACTS

Inappropriate verbal and physical sexual behaviour is not common among individuals with dementia, but when it does occur, it can have profound consequences. We report a case of 79-year-old woman with dementia of the Alzheimer’s type who complained of increased libido after an increased dose of Donepezil, which was being used along with tianeptine. Donepezil withdrawal led to the resolution of increased libido, but when it was reintroduced, increased libido reappeared once again (Naranjo score: 7). Increased libido was not reported by the patient during the 6-year follow-up period after Donepezil withdrawal. A potential mechanism of acetylcholinesterase inhibitor-induced increased libido

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.do not store above 30oc

Medicine does not require any special handling for disposal.

Keep out of the reach of children.

Medicine has a shelf life of 3 years; do not keep outdated medicine or medicine no longer needed.

REFERENCES

  • Journal of Clinical Neurophysiology:

February 2014 – Volume 31 – Issue 1 – p 81–85

doi: 10.1097/01.wnp.0000436899.48243.5e

Original Research

DONEPEZIL for the treatment of mild to moderate Dementia – Taj Dearob Pharma | Donepezil is an oral medication used for the treatment of mild to moderate dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality) in people who have Alzheimer’s disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities).
DONEPEZIL for the treatment of mild to moderate Dementia – Taj Dearob Pharma | Donepezil is an oral medication used for the treatment of mild to moderate dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality) in people who have Alzheimer’s disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities).