PMID- 30058285
OWN - NLM
STAT- MEDLINE
DCOM- 20190903
LR  - 20210109
IS  - 1755-5949 (Electronic)
IS  - 1755-5930 (Print)
IS  - 1755-5930 (Linking)
VI  - 24
IP  - 10
DP  - 2018 Oct
TI  - A review of clinical treatment considerations of donepezil in severe Alzheimer's 
      disease.
PG  - 876-888
LID - 10.1111/cns.13035 [doi]
AB  - BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder that affects 
      over 45 million people worldwide. Patients with severe AD require help with daily 
      activities and show severe memory impairment. Currently, donepezil is one of two 
      drugs approved by FDA and Health Canada for the treatment of severe AD (MMSE 
      score <10). It is prescribed as 5 or 10 mg/d and an FDA-approved 23-mg/d dose. 
      METHOD: This review will discuss risks and benefits of donepezil at these doses 
      in severe AD. Articles were identified using PubMed using the MeSH terms 
      "donepezil" AND "Alzheimer Disease" AND "severe." Three double-blind, 
      placebo-controlled, randomized studies, one post hoc analysis, and one subgroup 
      analysis were selected. RESULTS: Donepezil was found to benefit patients in 
      cognition and global functioning. The most consistent improvement was in severe 
      impairment battery (SIB) scores. However, more patients treated with high dosage 
      of donepezil discontinued their treatment due to various adverse events (AEs). 
      CONCLUSION: Clinicians must weigh benefits against adverse events when 
      determining the course of therapy, as recommendations for cholinesterase 
      inhibitors in advanced AD remain unclear and vary with different guidelines.
CI  - (c) 2018 John Wiley & Sons Ltd.
FAU - Adlimoghaddam, Aida
AU  - Adlimoghaddam A
AUID- ORCID: 0000-0003-1066-4196
AD  - Division of Neurodegenerative Disorders, St. Boniface Hospital Research, 
      Winnipeg, MB, Canada.
AD  - Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, MB, 
      Canada.
FAU - Neuendorff, Melanie
AU  - Neuendorff M
AD  - Rady Faculty of Health Sciences, Max Rady College of Medicine, University of 
      Manitoba, Winnipeg, MB, Canada.
FAU - Roy, Banibrata
AU  - Roy B
AD  - Department of Community Health Sciences, Faculty of Health Sciences, College of 
      Medicine, University of Manitoba, Winnipeg, MB, Canada.
AD  - Institutional Research and Assessment, Community College of Aurora, Denver, 
      Colorado.
FAU - Albensi, Benedict C
AU  - Albensi BC
AD  - Division of Neurodegenerative Disorders, St. Boniface Hospital Research, 
      Winnipeg, MB, Canada.
AD  - Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, MB, 
      Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20180729
PL  - England
TA  - CNS Neurosci Ther
JT  - CNS neuroscience & therapeutics
JID - 101473265
RN  - 0 (Cholinesterase Inhibitors)
RN  - 8SSC91326P (Donepezil)
SB  - IM
MH  - Alzheimer Disease/complications/*drug therapy
MH  - Cholinesterase Inhibitors/*therapeutic use
MH  - Cognition Disorders/*drug therapy/etiology
MH  - Donepezil/*therapeutic use
MH  - Humans
MH  - PubMed/statistics & numerical data
PMC - PMC6489741
OTO - NOTNLM
OT  - Alzheiemr's disease
OT  - cognition
OT  - dementia
OT  - donepezil
OT  - dose
OT  - severity
OT  - treatment considerations
EDAT- 2018/07/31 06:00
MHDA- 2019/09/04 06:00
PMCR- 2018/07/29
CRDT- 2018/07/31 06:00
PHST- 2018/04/09 00:00 [received]
PHST- 2018/06/28 00:00 [revised]
PHST- 2018/06/29 00:00 [accepted]
PHST- 2018/07/31 06:00 [pubmed]
PHST- 2019/09/04 06:00 [medline]
PHST- 2018/07/31 06:00 [entrez]
PHST- 2018/07/29 00:00 [pmc-release]
AID - CNS13035 [pii]
AID - 10.1111/cns.13035 [doi]
PST - ppublish
SO  - CNS Neurosci Ther. 2018 Oct;24(10):876-888. doi: 10.1111/cns.13035. Epub 2018 Jul 
      29.