Donepezil may be Useful in Moderate-to-Severe Alzheimer’s Disease

Patients with moderate or severe Alzheimer’s disease may benefit from treatment with donepezil, according to a recent study.

Alzheimer’s disease is a condition that affects the elderly resulting in memory loss. It progresses gradually from a mild to a more severe condition, ultimately making the patient extremely dependent on a caregiver.

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Drugs are currently available that help to improve symptoms in people with Alzheimer’s disease, though they cannot stop the progression of the disease. One such drug is donepezil, which is beneficial in mild-to-moderate cases.

Another drug memantine is also used to treat Alzheimer’s disease, though it acts via a different mechanism as donepezil. It is usually prescribed for the moderate-to-severe stages.

A study recently published in the New England Journal of Medicine evaluated the benefit of donepezil and memantine in people suffering from moderate-to-severe Alzheimer’s disease. The study was conducted in 295 patients who had received donepezil for at least 3 months. In the study, the patients were prescribed donepezil, memantine, both the drugs, or neither for a duration of 52 weeks.

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Patients who continued to take donepezil when the Alzheimer’s disease worsened did better than those who discontinued donepezil. Patients on donepezil showed significantly less decline in memory and retained the ability to carry out simple daily tasks and self-care.

Patients who received memantine also did better than those who did not receive memantine, but the benefit was smaller as compared to that of donepezil.

Donepezil

This medication is a cholinesterase inhibitor, prescribed for dementia of Alzheimer's disease.

However, combining the two drugs did not provide any additional benefit.

The study thus concluded that donepezil continues to provide its benefits in moderate or severe Alzheimer’s disease. Neither drug could halt the progression of the disease. More research is required regarding the long-term benefits and possible adverse effects of using donepezil over prolonged durations.

Memantine

This medication is an N-methyl-D-aspartate (NMDA)-receptor antagonist, recommended for Alzheimer's disease. It reduces abnormal activity in the brain, improve the thinking ability and help perform daily activities more easily.

Reference:

1. Donepezil and Memantine for Moderate-to-Severe Alzheimer's Disease; Robert Howard et al; N Engl J Med 2012; 366:893-903.

Source-Medindia