From the Guidelines
Aricept (Donepezil) is primarily used to improve cognition and global function assessment in patients with Alzheimer's disease and vascular dementia.
Key Uses
- The medication is effective in improving cognitive symptoms, particularly in patients with mild to moderate Alzheimer's disease and vascular dementia 1.
- Donepezil has been shown to have a positive effect on global function assessment, as measured by the CIBIC-plus score, in patients with mild to moderate Alzheimer's disease 1.
- The typical dosage of donepezil is 5-10 mg per day, with most studies evaluating the 10 mg per day dose 1.
Adverse Effects
- Common adverse effects of donepezil include gastrointestinal problems, such as diarrhea, nausea, and vomiting, which are dose-related 1.
- The overall quality of reporting harms was moderate to low, but most studies found that the adverse effects were manageable and did not lead to significant discontinuation of the medication 1.
Clinical Significance
- While the average change in cognitive score with donepezil treatment was statistically significant, it did not reach a clinically significant level in most studies 1.
- However, a subset of patients may experience clinically important improvements in cognition with donepezil, although the evidence is not sufficient to determine which patients are most likely to benefit 1.
From the FDA Drug Label
DONEPEZIL HYDROCHLORIDE tablets, for oral use Initial U. S. Approval: 1996 INDICATIONS AND USAGE Donepezil is an acetylcholinesterase inhibitor indicated for the treatment of dementia of the Alzheimer’s type. Efficacy has been demonstrated in patients with mild, moderate, and severe Alzheimer’s Disease (1)
The use of Aricept (Donepezil) is for the treatment of dementia of the Alzheimer’s type, with demonstrated efficacy in patients with mild, moderate, and severe Alzheimer’s Disease 2.
From the Research
Use of Aricept (Donepezil)
- Aricept (Donepezil) is indicated for the symptomatic treatment of mild to moderate Alzheimer's disease 3, 4, 5, 6
- It is a specific and reversible inhibitor of acetylcholinesterase (AChE), which increases levels of available acetylcholine in the brain, compensating for the loss of functioning cholinergic brain cells 3, 4
- Donepezil has been shown to have efficacy against the three major domains of Alzheimer's disease symptoms, namely functional ability, behavior, and cognition 3
- The strongest evidence is for improvement or less deterioration in global outcomes and cognition in the short to medium term 3
- Donepezil may also maintain function in the long term and has some level 1 and 2 evidence of improved or limited deterioration in behavior or mood in the short to medium term 3
- Additionally, donepezil has been shown to be effective in early-stage AD, vascular dementia, Parkinson's disease dementia/Lewy body disease, and cognitive symptoms associated with multiple sclerosis 6
Clinical Benefits
- Donepezil has been shown to improve cognitive function, as assessed by the Alzheimer's disease Assessment Scale-cognitive subscale (ADAS cog) 4
- It has also been shown to improve global function and activities of daily living in patients with mild to moderate AD 4
- Donepezil may lessen caregiver burden and may be cost effective, especially when unpaid caregiver costs are considered 3, 5