Donepezil: A Review of Pharmacological Characteristics and Role in the Management of Alzheimer Disease

摘要: Donepezil is a potent, selective, noncompetitive, and rapidly reversible inhibitor of acetylcholinesterase (AChEI) licensed for the treatment Alzheimer disease (AD); first only AChEI severe AD. Its efficacy as monotherapy, or in combination with NMDA-agonist, memantine, has been documented several randomised double-blind, placebo-controlled, short-term clinical trials, well long-term extension trials observational studies. tolerated drug that generally safe demonstrated even patients multiple co-morbidities receiving polypharmacy. It shown donepezil improves cognition global function mild-to-moderate AD; maintained up to 50 weeks. There dose-response relationship, higher doses more likely produce symptomatic benefit. Furthermore, donepezil- treated may improve cognitively show improvement all stages, including Less consistent results stages were obtained on measures behavior, observations mood. No effect transition AD found long-term, randomized mild cognitive impairment (MCI). Cost-effectiveness questioned by one open-label societal study 2-years duration. This reported modest but no statistically significant benefits during compared placebo, terms rates institutionalization progression toward greater disability. However, there need further research clinically meaningful outcomes favored caregivers, which are traditionally not defined trials. Likewise, we know how select responders, what an optimal AChE inhibition particularly treatment, dosage should be increased sustained benefit, duration when stop treatment. After almost two decades use everyday practice these issues still unresolved.