Donepezil use in Alzheimer disease

Area of Science:

• Pharmacology and Therapeutics
• Neuroscience
• Geriatric Medicine

Background:

• Alzheimer disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline.
• Current treatments aim to manage symptoms and improve quality of life for patients.
• Cholinesterase inhibitors are a key class of drugs used in AD management.

Purpose of the Study:

• To comprehensively review donepezil's pharmacology, pharmacokinetics, clinical efficacy, and safety.
• To evaluate donepezil's therapeutic role in managing Alzheimer disease.
• To identify potential drug-drug interactions and adverse effects associated with donepezil.

Main Methods:

• Literature search of MEDLINE (1985-1997) and bibliographies for relevant articles.
• Inclusion of approved product labeling for data extraction.
• Assessment of literature for adequate patient description, methodology, and outcomes.

Main Results:

• Donepezil is a selective acetylcholinesterase inhibitor, orally bioavailable and unaffected by food.
• Clinical trials demonstrated donepezil's efficacy in improving cognitive function and global impression in mild-to-moderate AD.
• Adverse effects were comparable to placebo, with no need for liver function monitoring.

Conclusions:

• Donepezil is an effective symptomatic treatment for mild-to-moderate Alzheimer disease.
• It presents a safe alternative to tacrine due to once-daily dosing, minimal adverse effects, and lower cost.
• Further comparative trials are warranted to solidify its position in AD therapy.