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Open-label study of donepezil in traumatic brain injury
C A Masanic1, M T Bayley, R VanReekum
1Hamilton Health Sciences Corp, Division of Physical Medicine and Rehabilitation, Department of Medicine, McMaster University, Hamilton, Ont, Canada.
Objective:
To determine preliminarily whether donepezil will improve memory, behavior, and global function after chronic traumatic brain injury (TBI).
Design:
Sixteen-week open-label study.
Setting:
Outpatient TBI rehabilitation program.
Patients:
Four patients with chronic, severe TBI.
Interventions:
Donepezil 5mg daily for 8 weeks followed by 10mg daily for 4 weeks.
Main Outcome Measures:
Memory measures included the Rey Auditory Verbal Learning Test (RAVLT), the Complex Figure Test (CFT), items from the Rivermead Behavioural Memory Test (RBMT), and a semantic fluency task. The Neuropsychiatric Inventory (NPI) evaluated behavior and affect. Function was assessed by using the FIM instrument and a clinical global impression of change.
Results:
On the RAVLT, the mean scores for learning and short- and long-term recall improved by 0.4, 1.04, and.83 standard deviations (SDs) above baseline, respectively. On the CFT, the mean scores for short-term recall and long-term recall improved by 1.56 and 1.38 SDs above baseline, respectively. A positive trend was observed on the RBMT and on the NPI subscales.
Conclusions:
Donepezil may improve some aspects of memory and behavior in persons with chronic TBI. Randomized clinical trials are required to support these preliminary findings.