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Related Experiment Videos

[Extra-pyramidal syndrome induced by donepezil].

D Carcenac1, C Martin-Hunyadi, M Kiesmann

  • 1Hôpital de Jour d'Evaluation Gériatrique et Gérontologique Saint-François, CHUR de Strasbourg.

Presse Medicale (Paris, France : 1983)
|June 22, 2000
PubMed
Summary

Acetylcholinesterase inhibitors, used for Alzheimer's disease, may cause extra-pyramidal side effects. Discontinuing donepezil resolved these effects in some patients, suggesting drug interactions.

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Geriatrics

Background:

  • Alzheimer's disease is often treated with acetylcholinesterase inhibitors based on the cholinergic hypothesis.
  • These medications typically have mild side effects, primarily gastrointestinal issues.

Observation:

  • Three patients with Alzheimer's dementia experienced severe extra-pyramidal side effects, including gait disturbances, while on donepezil.
  • These adverse events occurred when donepezil was co-administered with paroxetine or a neuroleptic medication.

Findings:

  • In two out of three cases, the extra-pyramidal symptoms resolved after discontinuing donepezil.
  • This suggests a potential link between donepezil, especially in combination therapy, and the development of extra-pyramidal side effects.

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Implications:

  • Extra-pyramidal syndromes in elderly patients with cognitive impairment are complex to diagnose.
  • Potential drug interactions between acetylcholinesterase inhibitors, neuroleptics, and SSRIs, as well as Lewy body dementia, should be considered in differential diagnosis.