Cognition-Enhancing Effects of Donepezil in Traumatic Brain Injury

Abstract

The purpose of this study was to investigate the effects of donepezil, a cholinergic agent, on chronic cognitive impairment due to traumatic brain injury (TBI). Chronic patients underwent two standardized neuropsychological evaluations – one before and the other 3 months following treatment with donepezil. Together with global inventories that appraised behaviour, fatigue, anxiety and depression, these evaluations also assessed executive functioning, memory and attention. Of the 10 patients who followed the therapy, 8 reported subjective improvement in at least one cognitive domain following therapy and most of them reported better functioning in everyday activities. This effect was supported by a slight global improvement when considering the global score of the different affectivo-behavioural scales. At the neuropsychological level, although we could observe a slight improvement in the majority of the considered tests, significant positive changes were mainly found in tests assessing speed of processing, learning and divided attention. These findings suggest that donepezil may lead to better general functioning and improve attentional skills in patients with chronic TBI.

Acute cognitive effects of donepezil in young, healthy volunteers

“…Changes in mood after chronic administration of donepezil (Khateb et al, 2005;Risch et al, 2006;Cummings et al, 2006;Devi et al, 2007) have been reported before, but have been ignored at large in studies of acute doses. Also, donepezil has been found to be useful in the management of behavioral disregulation, apathy, irritability, psychosis, depres-sion, mania, tics, and delirium and in the diagnosis of depression, panic, and personality disorders (Burt, 2000).…”

A systematic review of fatigue in patients with traumatic brain injury: The course, predictors and consequences

“…2) Ponsford et al, 2012;De Leon et al, 2009;Lundin et al, 2006;Meares et al, 2011;Mickeviciene et al, 2004;Norrie et al, 2010;van der Naalt et al, 1999;Yang et al, 2009;McLean et al, 1993;Sundstrom et al, 2007;Hutchinson et al, 2009;Sigurdardottir et al, 2009;Kempf et al, 2010;Driver and Ede, 2009;Gemmell and Leathem, 2006;Bushnik et al, 2008a;Jha et al, 2008;Kaiser et al, 2010;Khateb et al, 2005;Schoenberger et al, 2001;Hou et al, 2012). Supplementary Table 2 reports reasons for exclusion of 11 studies (Bhambhani et al, 2008;Bateman et al, 2001; Table 4 Quality assessment of studies using guidelines developed by Hayden et al (2006).…”

Pharmacological management of neurobehavioral disorders following traumatic brain injuryA state-of the-art review

“…One randomized crossover trial demonstrated attention and memory benefits with donepezil therapy, which were sustained after the washout period [79]. Another case series reported subjective improvement and improvement in processing speed, verbal memory, and divided attention in 8 of 10 subjects treated with donepezil [80].…”

“…A number of case series report positive effects of donepezil on learning and memory in chronic severe TBI [80,[93][94]. However, a multicenter, randomized, doubleblind placebo-controlled study found no significant effect on memory with rivastigmine [81].…”