Donepezil in the treatment of progressive supranuclear palsy

Objectives - To evaluate the effect of 3 month therapy with donepezil, a ce ntrally acting cholinesterase inhibitor, on cognitive performances, motor f unction and daily living activities in progressive supranuclear palsy (PSP) . Materials and methods - Six patients with a diagnosis of PSP were evaluat ed at baseline and after 3 months of treatment with donepezil, 10 mg given at bedtime. Cognitive functions, motor symptoms and daily activities were e valuated by means of appropriate rating scales. Results - Donepezil was not effective on cognitive dysfunction and did not change ratings of daily liv ing. Parkinsonian symptoms were unaffected by donepezil treatment. Conclusi ons Cholinergic replacement therapy alone is not likely to improve symptoms in a disorder characterized by a more widespread impairment of monoaminerg ic systems. Larger studies may be necessary to confirm the lack of effect o f donepezil in this disorder.