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Donepezil minimally effective for patients with vascular dementia
PRACTICE RECOMMENDATIONS

Donepezil (Aricept—a potent acetylcholin-esterase inhibitor) had small effects on mentation for patients with mild to moderate vascular dementia as measured by validated instruments of cognition.

Donepezil’s side effects are similar to placebo at 5 mg but double at 10 mg, with no improvement in the patient’s cognition. Even though this medication was minimally effective, there are no other highly effective medical treatments for vascular dementia. Therefore, if a patient chooses a trial of donepezil, the lower, 5-mg dose should be offered.

The medication’s effect is likely a class effect and not an individual drug effect; therefore, rivastigmine (Exelon) and galantamine(Reminyl) are 2 other acetylcholinesterase inhibitors that should also be considered. Cost is similar for all 3 drugs at about $130.00 per month.

 
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Practice Recommendations from Key Studies

Black S, Román GC, Geldmacher DS, et al; Donepezil 307 Vascular Dementia Study Group. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke 2003; 34:2323–2332.

Kenneth H. Johnson, DO
Family Practice Residency Program, Eastern Maine Medical Center, Bangor, Maine. E-mail: [email protected].

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The Journal of Family Practice - 53(3)
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172-188
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Practice Recommendations from Key Studies

Black S, Román GC, Geldmacher DS, et al; Donepezil 307 Vascular Dementia Study Group. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke 2003; 34:2323–2332.

Kenneth H. Johnson, DO
Family Practice Residency Program, Eastern Maine Medical Center, Bangor, Maine. E-mail: [email protected].

Author and Disclosure Information

Practice Recommendations from Key Studies

Black S, Román GC, Geldmacher DS, et al; Donepezil 307 Vascular Dementia Study Group. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke 2003; 34:2323–2332.

Kenneth H. Johnson, DO
Family Practice Residency Program, Eastern Maine Medical Center, Bangor, Maine. E-mail: [email protected].

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PRACTICE RECOMMENDATIONS

Donepezil (Aricept—a potent acetylcholin-esterase inhibitor) had small effects on mentation for patients with mild to moderate vascular dementia as measured by validated instruments of cognition.

Donepezil’s side effects are similar to placebo at 5 mg but double at 10 mg, with no improvement in the patient’s cognition. Even though this medication was minimally effective, there are no other highly effective medical treatments for vascular dementia. Therefore, if a patient chooses a trial of donepezil, the lower, 5-mg dose should be offered.

The medication’s effect is likely a class effect and not an individual drug effect; therefore, rivastigmine (Exelon) and galantamine(Reminyl) are 2 other acetylcholinesterase inhibitors that should also be considered. Cost is similar for all 3 drugs at about $130.00 per month.

 
PRACTICE RECOMMENDATIONS

Donepezil (Aricept—a potent acetylcholin-esterase inhibitor) had small effects on mentation for patients with mild to moderate vascular dementia as measured by validated instruments of cognition.

Donepezil’s side effects are similar to placebo at 5 mg but double at 10 mg, with no improvement in the patient’s cognition. Even though this medication was minimally effective, there are no other highly effective medical treatments for vascular dementia. Therefore, if a patient chooses a trial of donepezil, the lower, 5-mg dose should be offered.

The medication’s effect is likely a class effect and not an individual drug effect; therefore, rivastigmine (Exelon) and galantamine(Reminyl) are 2 other acetylcholinesterase inhibitors that should also be considered. Cost is similar for all 3 drugs at about $130.00 per month.

 
Issue
The Journal of Family Practice - 53(3)
Issue
The Journal of Family Practice - 53(3)
Page Number
172-188
Page Number
172-188
Publications
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Donepezil minimally effective for patients with vascular dementia
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Donepezil minimally effective for patients with vascular dementia
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