Donepezil for dementia due to Alzheimer's disease

Trials lasting up to 12 months show that taking daily doses of either 5mg or 10mg donepezil improves cognition and global clinical state in patients with Alzheimer's disease.

This conclusion was drawn from a systematic review of 23 trials that involved a total of 5,272 participants, and is published in the latest update of The Cochrane Library.

Benefits of treatment were also seen on measures of activities of daily living and behaviour, but not on the quality of life score. The benefits are small, but for people with Alzheimer’s disease they can often be important.

Alzheimer’s disease may be involved in up to 80% of cases of dementia. Donepezil inhibits the breakdown of acetylcholine, an important neurotransmitter associated with memory, and lessens the impact of the loss of neurons in Alzheimer’s disease.

The Review Authors found that a 10mg daily dose gave only marginally greater benefit than 5mg, but produces more side effects. “Considering the better tolerability and lower costs, the lower dose may be the better option for most patients,” says lead author Jacqueline Birks who works in the Department of Clinical Geratology at the University of Oxford, UK.