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P3–455: Donepezil treatment for Alzheimer's disease in chronic dialysis patients
Author(s) -
Yiannopoulou Konstantina G.,
Euthymiou Athina K.,
Karydakis Kleanthis D.
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.1726
Subject(s) - donepezil , medicine , dialysis , hemodialysis , renal function , kidney disease , disease , dementia
Background: Donepezil is one of the cholinesterase inhibitors that are indicated for the treatment of mild to moderate Alzheimer’s Disease. Pharmacokinetic analysis has shown that donepezil is primarily eliminated by renal excretion rather than biliary excretion in humans. Therefore, patients with impaired renal function are at high risk for toxicity caused by accumulation of this drug. It is also well known that dialysis patients have very often cholinergic disorders. On the other hand, with the increasing number of long-term chronic dialysis patients, the prevalence of cognitive disorders is increasing in the elderly of them. Because of the above mentioned special risks, prescription of acetylocholinesterase inhibitors, such as donepezil, to be avoided is prescribed. There is only one study that evaluates the pharmacokinetics of donepezil in patients with impaired renal function and only one case-report with donepezil treatment in a chronic-dialysis patient. Objectives: This pilot study aimed to investigate whether there is a safe dose of donepezil to be administered in chronic dialysis patients with Alzheimer’s disease and if this treatment offers a possible benefit to them. Methods: We studied three cases of chronic hemodialysis outpatients (2 men and 1 woman, 72, 86 and 65 years old respectively), that were diagnosed as having moderate Alzheimer’s disease. Study subjects underwent a baseline clinical and laboratory assessment and a neuropsychological examination (including MMSE, GDS, NPI and IADL scale), that it was repeated every month. All patients were followed for 6 months. We began treatment with donepezil on the lower dose of 2.5mg/day orally and we enhanced the dose to 5mg/day one month later. Results: After 1 month’s treatment, they improved to a controllable psychiatric condition, without having any adverse effects. After 3 months of treatment with the higher dose, their cognitive and executive functions were slightly improved and their behavior was remarkably improved, without experiencing any episodes of drug toxicity. The patients’ condition remained stable for 6 months after the initial administration of the drug. Conclusion: Our cases indicate that donepezil treatment under prudent use may be well tolerated and have a beneficial impact on chronic hemodialysis patients with Alzheimer’s disease. P3-456 DIFFERENTIAL QUANTITATIVE EEG EFFECTS OF RIVASTIGMINE AND MEMANTINE IN ALZHEIMER PATIENTS