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Related Concept Videos

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Related Experiment Video

Updated: May 2, 2026

Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
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Donepezil-induced mania.

Jonathan G Leung1

  • 1Mayo Clinic, Rochester, Minnesota.

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
|March 5, 2014
PubMed
Summary
This summary is machine-generated.

Donepezil titration can trigger mania in elderly patients, even those with schizophrenia. Discontinuing the medication resolved manic symptoms, highlighting a potential adverse effect for clinicians to monitor.

Keywords:
ADE = Adverse drug eventAcetylcholinesterase inhibitorBipolar disorderDonepezilDrug-induced maniaGI = GastrointestinalMania

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Area of Science:

  • Psychiatry
  • Geriatric Medicine
  • Pharmacology

Background:

  • Donepezil is commonly prescribed for Alzheimer's disease.
  • Its use in patients with psychiatric conditions is less established.
  • Elderly patients may be more susceptible to medication side effects.

Observation:

  • A 70-year-old male with schizophrenia and cognitive impairment developed mania.
  • Symptoms included hyperverbalization, elevated mood, agitation, and decreased sleep.
  • These symptoms emerged after donepezil dosage was increased to 10 mg daily.

Findings:

  • The patient's manic symptoms resolved completely within two weeks of discontinuing donepezil.
  • This case suggests a link between donepezil titration and the onset of mania.
  • Prior studies have noted mania with off-label donepezil use in bipolar disorder.

Implications:

  • Clinicians should consider mania as a potential adverse effect of donepezil, especially during titration.
  • Awareness is crucial for all patients receiving donepezil, not just those with known bipolar disorder.
  • This case underscores the importance of careful medication monitoring in elderly psychiatric patients.