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

Currently,Aricept there is no definitive proof that Aricept use of donepezil or Aricept other similar agents altersAricept the course or progressionAricept of Alzheimer's disease.Aricept However, 6-12 month controlled studies have shown modest benefits in cognition and/orAricept behavior. AriceptPilot studies have reported Aricept that donepezil Aricept therapy may potentially have effects on markers of disease Aricept progression, such Aricept as hippocampal volume. Therefore, many neurologists, psychiatrists, and primary care physicians use donepezil in Aricept patients with Alzheimer's disease. Aricept In 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 Aricept functional outcome; of Aricept quality of life or of behavioral symptoms.Aricept However, NICE revised its guidelines to suggest that donepezil be used in moderate stage patients Aricept for whom the evidence is strongest. While the drug is currently indicated for mild to moderate Alzheimer's, there is also evidence from 2Aricept trials that it may be effective for moderate to severe disease. An example ofAricept this is a Karolinska Institute paper published in The Lancet in Aricept early 2006, which states that donepezil improves cognitive function even Aricept in patients with severe Alzheimer's disease symptoms.

Donepezil is sometimes Aricept used in combination with Memantine, a newer agent for Alzheimer's disease,Aricept as the response to both together is considered superior to donepzil alone. Aricept In moderate to severe Alzheimer's, a controlled clinical trial has shown that the addition of Memantine to stable donepezil therapy improves cognition, functioning Aricept and behavior.

Donepezil has been tested in Aricept other cognitive disorders including Lewy body dementia and Vascular dementia,Aricept but it is not currently approved for these indications. Donepezil has also Aricept been studied in patients with Mild Cognitive Impairment, schizophrenia, attention deficit disorder, post-coronary bypass cognitive impairment,Aricept cognitive impairment associated with multiple sclerosis, and Down syndrome. AriceptA 3 year NIH trial in patients with mild cognitive impairment reported that donepezil was superior to placebo in delaying rate of progression to dementia Aricept during the initial 18 months of the study but this was not sustained at 36 months. Aricept In a secondary analyses, a subgroup of individuals with the ApolipoproteinAricept E4 genotype showed sustained benefits with donepezil throughout the study.Aricept However at this time donepezil is not indicated for prevention Aricept of dementia.

Donepezil is generally Ariceptbetter tolerated than others in its class, simpler to use, and the agent with the most number of well controlled clinical trials. Common side effects include nausea, Aricept diarrhea, anorexia, abdominal pain, and vivid dreams. In 2006, Eisai, the manufacturer issued a statetment that a single vascular dementia study found a difference Aricept in the percent of study participants who died in the donepezil group (1.7%) Aricept versus the placebo group (0%) and that this could be due to an unusually low Aricept death rate on the placebo group. An analysis of all three Vascular Dementia Aricept trials, according to Eisai, "shows no statistically significant differences Aricept in observed mortality rates between the donepezil and Aricept placebo groups (1.7% vs. 1.1%)".


In July 2002, a pilot study, Aricept reported that donepezil improves the memory of aging pilots. The researchers Aricept trained pilots in a flight simulator to perform specific maneuvers and to respond to emergencies that developed during their mock flight, after giving half the Ariceptpilots donepezil and half a placebo. One month later they retested the pilots and found that those who had taken the donepezil remembered their trainingAricept better, as shown by improved performance. However, several other Aricept studies in normal older adults (before and after the above study) have not Aricept shown any significant cognitive improvements or shown inconsistent Aricept findings.