Donepezil is a drug that has been approved by the FDA and has information on side effects and uses.
Aricept is a medication used to treat Alzheimer's disease.It appears to result in a small benefit.The progression of the disease has not been changed by use.If no benefit is seen, treatment should be stopped.It is taken by mouth.[5]
Nausea, trouble sleeping, aggression, diarrhea, feeling tired, and muscle cramps are some of the common side effects.There are serious side effects that include abnormal heart rhythms, frequent urge to urinate, and seizures.Donepezil is not related to other anticholinesterase agents.[4]
In 1996 Donepezil was approved for use in the US.It is a generic medication.It was the 128th most prescribed medication in the United States, with more than 5 million prescriptions.[8]
There is no evidence that donepezil or similar agents change the course of Alzheimer's disease.Six-to-twelve-month controlled studies have shown modest benefits.The UK National Institute for Clinical excellence recommends donepezil as an option in the management of mild to moderate Alzheimer's disease.If there is no significant benefit, the person should be stopped.The FDA approved donepezil for the treatment of mild, moderate and severe dementia in Alzheimer's disease.[13]
In clinical trials nausea and vomiting were the most common adverse events.Other side effects included difficulty sleeping and loss of appetite.Most side effects were observed in patients taking the lower dose.Most patients have side effects that last up to three weeks and usually improve with continued use.[15]
Donepezil can cause nightmares due to enhanced activation of the visual association cortex during REM sleep.Dosing donepezil in the morning can reduce nightmares.[2]
Donepezil should be used with caution in people with heart disease.[15]
People with peptic ulcer disease should use caution because of the increased risk of gastrointestinal bleeding.People with heart problems were also seen with slow heart beats.When starting treatment or increasing the dose, these symptoms may become more frequent.People who have a tendency to have seizures should be cautious.[15]
If daily donepezil has been suspended for 7 days or less, restarting at the same dose is recommended.[16][17]
Donepezil inactivates the cholinesterases.This increases the concentration of acetylcholine in the brain.[2]
The mechanism of action of donepezil in patients with Alzheimer's disease is not fully understood.It is generally accepted that the symptoms of Alzheimer's disease are related to the cholinergic deficit in the cerebral cortex and other areas of the brain.The formation of the Hippocampal contributes to the control of attention, memory and learning.There is a correlation between the severity of cognitive impairment and the loss of cholinergic neurons in the central nervous system.
Donepezil has been found to act as a potent agonist of the 1 receptor, and has shown to produce specific antiamnestic effects in animals.[20]
There are also noncholinergic mechanisms that have been proposed.Donepezil increases the nicotinic receptors in the cortical neurons.It is unlikely that this action will contribute to clinical effects.[2]
The United States Food and Drug Administration (USFDA) approved donepezil under the brand Aricept, which it co-marketed with Pfizer, in 1996.Hachiro Sugimoto was the leader of the team.[ 24]