Aricept

Aricept Description & Uses

Aricept (Donepezil), marketed under the trade name Aricept® (Eisai), is a centrally acting reversible acetyl cholinesterase inhibitor. Its main therapeutic use is in the treatment of Alzheimer's disease where it is used to increase cortical acetylcholine. It is well absorbed in the gut with an oral bioavailability of 100% and easily crosses the blood-brain barrier. Because it has a half life of about 70 hours, it can be taken once a day. Initial dose is 5 mg per day, which can be increased to 10 mg per day after an adjustment period of at least 4 weeks.

The clinical utility of Aricept is controversial. Presently, there is no proof that use of donepezil or other similar agents alters the course or progression of Alzheimer's disease. However, controlled studies have shown modest benefits in cognition and behavior with this and similar agents. Therefore, many neurologists, psychiatrists, and primary care physicians use donepezil in patients with Alzheimer's disease. As of the 22 March 2005, the UK National Institute for Clinical Excellence (NICE) withdrew its recommendation for use of the drug for mild-to-moderate AD, on the basis that there is no significant improvement in functional outcome; of quality of life or of behavioral symptoms. However, these data conflict with those of other reports, as is often the case in medicine.

Aricept is sometimes used in combination with Memantine, a new agent for Alzheimer's disease which is in the same chemical class. The response to both together is superior to either alone.

Donepezil has been tested in other disorders which cause dementia including Lewy body dementia and Vascular dementia, but it is not currently approved for these indications.

Side Effects

Side effects include nausea, diarrhea, insomnia, vomiting, muscle cramp, fatigue and anorexia.

Also, Aricept can aggravate asthma and other breathing problems, and can increase the risk of seizures. It can also slow the heartbeat, cause heartbeat irregularities, and lead to fainting episodes. Contact your doctor if any of these problems occur.

In patients who have had stomach ulcers, and those who take a nonsteroidal anti-inflammatory drug such as Advil, Nuprin, or Aleve, Aricept can make stomach side effects worse. Be cautious when using Aricept and report all side effects to your doctor.

Aricept interactions

Drugs with anti-cholinergic properties that can cross into the brain, such as atropine, benztropine (Cogentin), and trihexyphenidyl (Artane) counteract the effects of donepezil and should be avoided during therapy with donepezil.

Donepezil is (eliminated) by enzymes in the liver. The rate of metabolism of donepezil may be increased by medications that increase the amounts of these enzymes, such as Tegretol, Decadron, Dilantin, and Rifadin. By increasing elimination, these drugs may reduce the effects of donepezil

Dosage

Usual starting dose is 5 milligrams once a day at bedtime for 4 to 6 weeks. Do not increase the dose during this period unless directed. Increases at the direction of a doctor to 10 milligrams once a day if response to the drug warrants it.

Recommended reading: The Mind Killer Defense