Donepezil (Aricept)

A similar treatment to Exalon (Revastigmine) and Reminyl (Galantamine). One of the messengers that carry instructions around the brain is called acetylcholine. Research has shown that there is not enough of this chemical in the brains of people who suffer with Alzheimer’s disease. An enzyme called aceycholinesterase breaks this chemical down and the drug donepezil (Aricept) can reduce this break down. Therefore aricept increases the amount of acetylcholine in the brain. Donepezil does not delay, stop or cure Alzheimer’s dementia; but improves early symptoms of the disease and slows progression

Donepezil (Aricept) treatment should be initiated by the consultant or a specialist clinician, although GPs may continue prescribing. Patients should be started on 5mg tablets and be increased to 10mg tablets after a month to maximise the effect of the drug. Tablets are taken once daily, preferably before bedtime

Donepezil has proven to be more effective for patients with mild to moderate symptoms of Alzheimer’s Disease. Alzheimer’s patients tend to have greater behavioural, sensorial, global and daily living activity improvements with 10mg of donepezil than 5mg, although side effects tend to be more frequent with 10mg than 5mg

Not all the Alzheimer patients improve with Donepezil, especially patients with more severe symptoms, so assessment may be done by your specialist clinician and if, after 3 months of treatment, patients do not respond, donezepil could be discontinued

The main side effects of Donepezil are gastrointestinal: nausea, vomiting, diarrhoea, affecting around 40% of the patients treated and, especially patients taking a higher dosage. When tablets are taken with food, these side effects can be minimised. Other common side effects are fatigue, anorexia, headache, dizziness, such as side effects are mild and decline with continued use of the drug. You will find a list of less common side effects in the leaflet given with the medication. Please make sure you have a copy the first time the medication is prescribed

Donepezil should never be prescribed for pregnant women or those who are breastfeeding. It is also advisable to take extra caution for patients who:
• suffer from arrhythmias ( such as sick sinus syndrome or other supraventricular conduction abnormalities),
• susceptible to peptic ulcers,
• are asthmatic and suffer from chronic obstructive pulmonary disease,
• suffer from extrapyramidal symptoms, as they may exacerbate them,
• suffer from liver problems

If other medication is required, such as cold remedies, do not forget to check with your pharmacist

Reproduced with kind permission of Maria Sanchez our Consultant Pharmacist