Does Donepezil (Aricept) cause vivid dreams?

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Last updated: May 19, 2025View editorial policy

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From the Guidelines

Aricept (donepezil) can cause vivid dreams as a side effect in some patients, as noted in the most recent and highest quality study available 1. This medication, commonly prescribed for Alzheimer's disease and other forms of dementia, works by increasing acetylcholine levels in the brain, which can affect sleep architecture and dream intensity. Some key points to consider:

  • Patients taking Aricept often report unusual or vivid dreams, particularly when the medication is taken in the evening.
  • If these vivid dreams become disturbing or disruptive to sleep, patients might consider taking Aricept in the morning rather than at bedtime, though this should only be done after consulting with their healthcare provider.
  • The typical dosage of Aricept ranges from 5-10 mg once daily, and these sleep-related side effects may diminish over time as the body adjusts to the medication.
  • Other common side effects can include nausea, diarrhea, and muscle cramps, as well as nightmares and bradyarrythmia, as reported in the study 1.
  • Patients experiencing persistent or troubling vivid dreams should discuss this with their doctor, who may adjust the dosage or recommend alternative treatments. It's also worth noting that the study from 2008 1 found that donepezil produces clinically meaningful improvements of cognitive and global function in patients with mild to moderate Alzheimer’s disease, but the clinical importance of these changes is uncertain. However, the most recent study from 2021 1 provides the most up-to-date information on the side effects of donepezil, including vivid dreams.

From the FDA Drug Label

Abnormal Dreams 0 3 The FDA drug label for donepezil (Aricept) reports abnormal dreams as an adverse reaction, occurring in 3% of patients, with 0% in the placebo group 2.

  • Key points:
    • Abnormal dreams are listed as an adverse reaction in the FDA drug label.
    • The frequency of abnormal dreams is 3% in the donepezil group.
    • This suggests that donepezil may cause vivid dreams or abnormal dreams in some patients.

From the Research

Aricept and Vivid Dreams

  • Aricept, also known as donepezil, is a medication used to treat Alzheimer's disease.
  • Research has shown that donepezil can influence the quality of sleep and dreams in patients with Alzheimer's disease 3.
  • A study published in 2005 found that taking donepezil in the evening can lead to an increased occurrence of nightmares in patients with dementia of the Alzheimer type (DAT) 3.
  • The study suggests that the activation of the visual association cortex during REM sleep is enhanced by donepezil, which can facilitate the development of nightmares in patients with DAT 3.
  • However, it is not clear if donepezil causes vivid dreams in general, as the study specifically looked at the occurrence of nightmares.
  • Other studies have focused on the effects of donepezil on cognitive function, immune response, and neuroprotection in Alzheimer's disease, but have not specifically addressed the topic of vivid dreams 4, 5, 6, 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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