Effects of Donepezil on Emotional/Behavioral Symptoms in Alzheimer's Disease Patients

Background: This open-label study examined the effects of the reversible cholinesterase inhibitor donepezil on emotional/behavioral symptoms in Alzheimer’s disease (AD) patients.

Method: Patients were diagnosed as havingprobable/possible AD by National Institute of Neurological andCommunicative Disorders and Stroke/Alzheimer’s Disease andRelated Disorders Association (NINCDS/ADRDA) criteria. This studyused the CERAD Behavior Rating Scale for Dementia (CBRSD) and itssubscales to evaluate a group of 25 AD patients treated withdonepezil. Dosage was increased at 4 months for most patientsfrom 5 to 10 mg q.h.s. Analysis of variance was used to comparescores over a period of 12 months. These patients were alsocompared, using t tests, to a reference group that had receivedno donepezil or other anticholinesterase.

Results: Donepezil administration was associatedwith improvement in Mini-Mental State Examination (MMSE) andCBRSD total scores at 3-month evaluation (p <= .05). CBRSDdepression and behavioral dysregulation scores improvedtransiently at 4 months (p <= .05). MMSE, CBRSD total, CBRSDdepression, and CBRSD behavioral dysregulation scores returned tobaseline levels at 12 months, in contrast to the reference group,whose MMSE and CBRSD total scores worsened minimally over the 12months.

Conclusion: Donepezil has a mildly positiveeffect on emotional/behavioral symptoms in AD in addition to itseffect on cognitive function.