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Posted by on Oct 8, 2018 in Parkinson's Disease | 0 comments

In a nutshell

This study examined the effect of donepezil for treating Parkinson’s disease. Results showed that donepezil [Aricept?] improved patient’s thought and behavior, but did not prevent the progression of Parkinson’s.

Some background

Parkinson’s disease is caused by the breakdown and death of nerves within the brain that are important for movement and coordination. Parkinsons can also cause psychosis, or feeling disconnected to reality.  The exact causes of Parkinson’s are unknown, but there have been links to genetic factors and environmental exposures. Acetylcholine is an important chemical within the brain. Donepezil prevents the breakdown of acetylcholine in the brain so it can have longer lasting effects. Donepezil has been shown to be an effective drug in improving the thought and understanding in patients of other diseases including Alzheimer’s. It is important to evaluate the effects of donepezil on improving Parkinson’s disease compared to no treatment.

Methods & findings

145 patients with Parkinson’s and no dementia received 5mg/day of donepezil or placebo for 96 weeks. Patients were 20-80 years old and were excluded from the study if they showed signs of dementia, schizophrenia, or were on treatment for anti-psychotic drugs in the last 12 weeks. Outcomes were assessed based upon primarily the Parkinson’s Psychosis Questionnaire and other scales.

After 96 weeks forty-six of the patients had developed psychosis during the study. There was no statistical difference in the number of patients that developed psychosis between the treatment and the non-treatment group. Over the two year period, patients on donepezil experienced improved thought and behaviour across all three questionnaires compared to patients on no treatment. The most common side effects from taking donepezil were hallucinations.

The bottom line

This study concluded that donepezil improved cognitive function for patients with Parkinson’s, but did not prevent the progression of disease.

The fine print

This study was a well-organised study, but it did not evaluate functional outcomes or different dosages of donepezil.

What’s next?

Consult your physician about different types of treatment for Parkinson’s.

Published By :

Journal of neurology, neurosurgery, and psychiatry

Date :

Aug 03, 2018

Original Title :

Early use of donepezil against psychosis and cognitive decline in Parkinson’s disease: a randomised controlled trial for 2 years.

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