Donepezil
Overview
Donepezil, marketed under the trade name Aricept, is a medication used in the palliative treatment of Alzheimer's disease. Donepezil is used to improve cognition and behavior of people with Alzheimer's, but does not slow the progression of or cure the disease.[1]
Chemistry
Donepezil is a piperidine derivative that functions as a reversible inhibitor of the enzyme acetylcholinesterase. The chemical structure of donepezil is fairly simple, consisting of a benzylpiperidine moiety linked to an indanone ring via a two-carbon spacer.[2]
Pharmacology
Donepezil binds and reversibly inactivates the acetylcholinesterase enzymes, thus blocking the breakdown of acetylcholine, an important neurotransmitter in the brain that is involved in memory and cognition.[3]
Clinical Use
Donepezil is used to treat symptoms of mild, moderate, and severe Alzheimer's disease. It can improve cognition and behavior, but it does not slow disease progression. Treatment should be started at the first symptoms of dementia and should be continued as long as it provides a benefit.[4]
Side Effects
Common side effects of donepezil include nausea, vomiting, loss of appetite, and increased frequency of bowel movements. Serious side effects can include allergic reactions, difficulty breathing, and seizures.[5]
Contraindications
Donepezil should not be used in people who are allergic to piperidine derivatives or to any of the other ingredients in the medication. It should be used with caution in people with a history of cardiac disease, asthma, or severe lung disease.[6]