Donepezil for the treatment of behavioral disturbances in Alzheimer's disease: a 6-month open trial

Behavioral and psychological signs of dementia (BPSD) are common clinical c haracteristics of Alzheimer's disease (AD). They result in patient and care givers distress, decreased quality of life and placement in nursing homes. Treatment of BPSD with antidepressant and antipsychotic medications is not without complications and serious adverse effects. The acetylcholinesterase inhibitors (AChEI) show preliminary promise as psychotropic agents possibl y able to improve BPSD in AD patients. The present study aimed to evaluate the effect of donepezil (an AChEI) as an only treatment for AD patients wit h BPSD. Ten consecutive AD patients hospitalized at a psychogeriatric ward due to BPSD were treated with donepezil for 24 weeks. Effect was measured u sing the NeuroPsychiatric Inventory (NPI). Significant reduction in the pre sence of delusions, irritability/lability and disinhibition were achieved a fter 24 weeks of donepezil treatment. This was accompanied by reduction in caregivers distress. The drug was well tolerated and all patients completed the study. Our findings complement the preliminary data that donepezil as well as other AChEIs are promising candidates for further study as psychotr opic agents positively affecting BPSD in AD patients. (C) 2001 Elsevier Sci ence Ireland Ltd. All rights reserved.