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Is donepezil useful for improving cognitive dysfunction in bipolar disorder?

¹503 Remington St., Fort Collins, Colorado 80524, United States. DepressionBipolarClinic@comcast.com

Journal of Affective Disorders

|September 11, 2007

Summary

Donepezil may improve cognitive dysfunction in some bipolar disorder patients, particularly bipolar II. However, it showed no benefit for bipolar I patients and may increase affective instability.

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Area of Science:

Neuroscience
Psychiatry
Pharmacology

Background:

Cognitive dysfunction significantly hinders recovery in bipolar disorder.
Effective treatments for cognitive deficits in bipolar disorder are limited.
Donepezil, used for Alzheimer's, is explored for bipolar cognitive issues, with concerns about mood destabilization.

Observation:

A naturalistic case series evaluated donepezil's efficacy in bipolar disorder patients with memory complaints.
Patients were assessed for memory improvement and psychiatric status changes.
The study included patients with Bipolar I, Bipolar II, and Bipolar Disorder Not Otherwise Specified (NOS).

Findings:

67% of patients reported memory improvement, with higher efficacy in Bipolar II (84%) and Bipolar NOS (50%) compared to Bipolar I (0%).
Donepezil was discontinued due to side effects in 9 patients and lack of response in 4.
Worsening affective symptoms led to discontinuation in 57% of Bipolar I patients, 2% of Bipolar II, and 25% of Bipolar NOS.

Implications:

Donepezil may be a potential treatment for cognitive problems in Bipolar II and Bipolar NOS.
Bipolar I patients did not benefit and showed a trend towards affective destabilization.
Further controlled studies are needed to confirm efficacy and safety in specific bipolar disorder subtypes.