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Efficacy of increasing donepezil in mild to moderate A lzheimer's disease patients who show a diminished response to 5 mg donepezil: a preliminary study
Author(s) -
Yatabe Yusuke,
Hashimoto Mamoru,
Kaneda Keiichiro,
Honda Kazuki,
Ogawa Yusuke,
Yuuki Seiji,
Ikeda Manabu
Publication year - 2013
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/psyg.12004
Subject(s) - donepezil , nausea , adverse effect , medicine , disease , pharmacology , dementia
Background With the recent approval of several new drugs, pharmacological management of A lzheimer's disease has become more complicated in J apan. The efficacy and safety of increasing the dose of donepezil to 10 mg daily were assessed in an open‐label study of patients with mild to moderate A lzheimer's disease who were showing a diminished response to 5 mg daily. Methods The subjects included 27 patients with mild to moderate probable A lzheimer's disease whose primary caregivers had confirmed progression of symptoms during treatment with donepezil 5 mg daily. The dose of donepezil was increased to 10 mg daily, and the A lzheimer's disease assessment scale‐cognitive subscale ( J apanese version), N europsychiatric I nventory, and Z arit caregiver burden interview scores were compared before and after dose escalation. Adverse events were also investigated. Results Efficacy was evaluated in 24 patients; three dropped out because of adverse reactions. The A lzheimer's disease assessment scale score showed significant improvement after dose escalation of donepezil ( P = 0.006). The total score of the N europsychiatric I nventory and the Z arit score showed no significant changes. However, the anxiety score of the N europsychiatric I nventory showed a significant increase ( P = 0.028). Safety assessment revealed that the dropout rate was 11.1% and adverse reactions occurred in 40.7%. Nausea (29.6%) and loss of appetite (22.2%) were common adverse reactions. Conclusions Because cognitive function showed improvement after increasing the dose of donepezil, the dosage of this drug should probably be adjusted based on the overall severity of A lzheimer's disease as well as the progression of cognitive dysfunction.