We present a case of Korsakoff's syndrome that was successfully treated wit
h high doses of donepezil, an inhibitor of acetylcholine esterase, known to
retard the progress of symptoms in Alzheimer's disease. The patient was a
46-year-old married Japanese woman who began to drink alcohol after she mar
ried. After several years of drinking she developed typical symptoms of the
Korsakoff syndrome. Donepezil was started after treatment with thiamine or
thiamine plus fluvoxamine had failed. Her amnestic symptoms as well as her
quality of Life improved markedly during donepezil treatment. Inhibition o
f acetylcholine esterase may be an effective treatment for Korsakoff's synd
rome.