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Aricept
Aka: Aricept, Donepezil
- See Also
- Acetylcholinesterase Inhibitor
- Dementia
- Dementia Management
- Rivastigmine (Exelon)
- Galantamine (Reminyl)
- Mechanism
- Acetylcholinesterase Inhibitor
- Indications
- Mild to Moderate Dementia (Folstein MMSE: 10-26)
- Adverse Effects
- See Acetylcholinesterase Inhibitor
- No hepatotoxicity
- Syncope and Torsades de Pointes (have been reported for Aricept, but not other Acetylcholinesterase Inhibitors)
- Dosing
- Start at 5 mg orally at bedtime
- Increase to 10 mg orally at bedtime after 4-6 weeks
- Increase to 23 mg orally at bedtime after 3 weeks at 10 mg dose
- Advantages
- Generic Aricept is the least expensive of the Cholinesterase Inhibitors ($11 for 30 tablets in 2017)
- Efficacy
- See Acetylcholinesterase Inhibitor
- As effective as Cognex (without the hepatotoxicity risk)
- Mini-Mental Status Exam changes
- Reduces decline by 3 points in 6 months
- Patient reverts to prior decline with Drug Withdrawal
- May be preferred over Galantamine
- Appears more effective than Galantamine
- Better tolerated than Galantamine
- Lanctot (2003) CMAJ 169:557-64 [PubMed]
- Long-term use of Donepezil has minimal to no effect
- Does not prevent Nursing Home placement
- Minimally improves cognition
- Does not protect against longterm functional decline
- Courtney (2004) Lancet 363:2105-15 [PubMed]
- References
- Epperly (2017) Am Fam Physician 95(12): 771-8 [PubMed]