Can Aricept (donepezil) cause insomnia?

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Last updated: June 3, 2025View editorial policy

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From the Guidelines

Aricept (donepezil) can cause insomnia as a side effect, with a notable effect size reported in patients with mild cognitive impairment. According to the study published in the Annals of Internal Medicine 1, insomnia was one of the adverse events with a statistically significant effect size in this patient group. The study found that the effect sizes for adverse events in patients with mild cognitive impairment were similar to those with vascular dementia, with the addition of insomnia.

The exact mechanism of donepezil-induced insomnia is not fully understood, but it is thought to be related to the increase in cholinergic activity in the brain, which can disrupt normal sleep patterns. The study 1 reported that the overall quality of reporting harms was moderate to low, but it did highlight the importance of considering the potential side effects of donepezil, including insomnia, when prescribing this medication.

Some key points to consider when taking Aricept (donepezil) and experiencing insomnia include:

  • Taking the medication in the morning rather than at night may help reduce sleep disturbances
  • The standard dosing for Aricept starts at 5 mg once daily and may be increased to 10 mg daily after 4-6 weeks if needed and tolerated
  • If insomnia persists despite changing the timing of administration, speaking with a healthcare provider may be necessary to consider alternative treatments or temporary sleep aids.

It is essential to weigh the potential benefits of donepezil against the potential risks, including insomnia, and to closely monitor patients for any adverse effects, as reported in the study 1.

From the FDA Drug Label

Most common adverse reactions in clinical studies of donepezil hydrochloride are nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, and anorexia Advise patients and caregivers that donepezil hydrochloride may cause nausea, diarrhea, insomnia, vomiting, muscle cramps, fatigue, and decreased appetite.

Aricept (donepezil) can cause insomnia as it is listed as one of the most common adverse reactions in clinical studies. This is directly stated in the drug label 2 and patient counseling information 2 and 2.

From the Research

Aricept and Insomnia

  • Aricept, also known as donepezil, is a medication used to treat Alzheimer's disease and has been reported to cause insomnia in some patients 3.
  • The exact mechanism of how Aricept causes insomnia is not fully understood, but it is thought to be related to its effects on the cholinergic system in the brain.
  • Studies have shown that donepezil can cause a range of side effects, including insomnia, nausea, vomiting, diarrhea, muscle cramps, fatigue, anorexia, and syncope 3, 4.
  • The incidence of insomnia as a side effect of donepezil has been reported to be relatively low, but it can still have a significant impact on the quality of life of patients taking the medication.

Factors Contributing to Insomnia

  • The dosage of donepezil may play a role in the development of insomnia, with higher doses potentially increasing the risk of insomnia 4, 5.
  • Individual differences in metabolism and sensitivity to the medication may also contribute to the development of insomnia in some patients 6.
  • Other factors, such as the presence of other medical conditions or the use of other medications, may also increase the risk of insomnia in patients taking donepezil.

Management of Insomnia

  • Patients experiencing insomnia while taking donepezil should consult their doctor to discuss possible management strategies, such as adjusting the dosage or switching to a different medication.
  • Lifestyle changes, such as establishing a regular sleep schedule and avoiding caffeine and alcohol before bedtime, may also help to alleviate insomnia symptoms.
  • Further research is needed to fully understand the relationship between donepezil and insomnia, and to develop effective strategies for managing this side effect in patients with Alzheimer's disease 7.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Donepezil: a clinical review of current and emerging indications.

Expert opinion on pharmacotherapy, 2004

Research

Donepezil for dementia due to Alzheimer's disease.

The Cochrane database of systematic reviews, 2018

Research

Donepezil for Alzheimer's disease.

Expert review of neurotherapeutics, 2007

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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