Donepezil-associated manic episode with psychotic features: a case report and review of the literature

Hategan, Ana; Bourgeois, James A.

doi:10.1016/j.genhosppsych.2015.09.004

Cited by 11 publications

(8 citation statements)

References 29 publications

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“…Donepezil also induced mania symptoms in patients with dementia. In a patient with AD who had a history of MDD, donepezil also induced mania [360]. The patient had no history of BPAD.…”

Section: The Use Of Ache Inhibitors For Mdd and Bpadmentioning

confidence: 94%

Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis

Walczak-Nowicka

Herbet

2021

IJMS

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Acetylcholinesterase (AChE) plays an important role in the pathogenesis of neurodegenerative diseases by influencing the inflammatory response, apoptosis, oxidative stress and aggregation of pathological proteins. There is a search for new compounds that can prevent the occurrence of neurodegenerative diseases and slow down their course. The aim of this review is to present the role of AChE in the pathomechanism of neurodegenerative diseases. In addition, this review aims to reveal the benefits of using AChE inhibitors to treat these diseases. The selected new AChE inhibitors were also assessed in terms of their potential use in the described disease entities. Designing and searching for new drugs targeting AChE may in the future allow the discovery of therapies that will be effective in the treatment of neurodegenerative diseases.

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“…Donepezil also induced mania symptoms in patients with dementia. In a patient with AD who had a history of MDD, donepezil also induced mania [360]. The patient had no history of BPAD.…”

Section: The Use Of Ache Inhibitors For Mdd and Bpadmentioning

confidence: 94%

Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis

Walczak-Nowicka

Herbet

2021

IJMS

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“…To illustrate this point, VNS has been shown to modulate neural plasticity and cortical excitability through activation of central cholinergic pathways, making it distinct from conventional antidepressants’ mode of action at the circuitry level . Despite the pre‐existing hypothesis of a pro‐cholinergic state leading to depression, recent evidence of cholinesterase inhibitors inducing mania challenges this notion . The role of the central cholinergic system in mood regulation may be more complex and nuanced than previously thought.…”

Section: Discussionmentioning

confidence: 99%

“…29,30 Despite the pre-existing hypothesis of a pro-cholinergic state leading to depression, 17 recent evidence of cholinesterase inhibitors inducing mania challenges this notion. 31 The role of the central cholinergic system in mood regulation may be more complex and nuanced than previously thought. Taken together, findings suggest that manic emergence occurring with VNS may partly be related to its central pro-cholinergic effect, although this hypothesis still needs further investigation.…”

Section: Casementioning

confidence: 99%

Emergence of mania in two middle‐aged patients with a history of unipolar treatment‐refractory depression receiving vagus nerve stimulation

et al. 2017

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These cases suggest that some patients with treatment-resistant depression may have a previously unrecognized bipolar disorder, triggered only by VNS. This report also provides evidence that VNS-induced manic switches, however serious and troubling to patients, can be managed safely, and that VNS maintenance can be continued for an extended period of time without manic relapses. Although the mechanism of action of VNS is not known, emerging evidence supports central nervous system dopaminergic and possibly cholinergic system involvement.

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“…Six cases of manic episodes associated to the use of acetylcholinesterase inhibitors (AChEIs) in patients with probable AD have been reported (Table 2 ) [ 27 - 31 ], two of which also had vascular alterations [ 29 , 30 ]. Three of these subjects had been previously diagnosed with BD type I [ 27 , 29 ], one of which had a late-onset [ 29 ], and two subjects had previous depressive symptoms [ 30 , 31 ], in one case arising during treatment with AChEIs, just before the occurrence of mania [ 31 ]. Only one patient had no personal history of psychiatric disorders [ 28 ].…”

Section: Bipolar Disorder and Manic-like Symptoms In Patients With De...mentioning

confidence: 99%

Bipolar Disorder and Manic-Like Symptoms in Alzheimer’s, Vascular and Frontotemporal Dementia: A Systematic Review

Elefante

Brancati

Torrigiani

et al. 2023

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Background: An increased risk of manic episodes has been reported in patients with neurodegenerative disorders, but the clinical features of bipolar disorder (BD) in different subtypes of dementia have not been thoroughly investigated. Objectives: The main aim of this study is systematically review clinical and therapeutic evidence about manic syndromes in patients with Alzheimer’s disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD). Since manic-mixed episodes have been associated with negative outcomes in patients with dementia and often require medical intervention, we also critically summarized selected studies with relevance for the treatment of mania in patients with cognitive decline. Methods: A systematic review of the literature was conducted according to PRISMA guidelines. PubMed, Scopus and Web of Science databases were searched up to February 2022. Sixty-one articles on patients with AD, VaD or FTD and BD or (hypo)mania have been included. Results: Manic symptoms seem to be associated with disease progression in AD, have a greatly variable temporal relationship with cognitive decline in VaD, and frequently coincides with or precedes cognitive impairment in FTD. Overall, mood stabilizers and electroconvulsive therapy may be the most effective treatments, while the benefits of short-term treatment with antipsychotic agents must be balanced with the associated risks. Importantly, low-dose lithium salts may exert a neuroprotective activity in patients with AD. Conclusion: Prevalence, clinical features and treatment response to pharmacotherapy of manic syndromes in patients with dementia may be differentially affected by the nature of the underlying neurodegenerative conditions.

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Donepezil-associated manic episode with psychotic features: a case report and review of the literature

Cited by 11 publications

References 29 publications

Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis

Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis

Emergence of mania in two middle‐aged patients with a history of unipolar treatment‐refractory depression receiving vagus nerve stimulation

Bipolar Disorder and Manic-Like Symptoms in Alzheimer’s, Vascular and Frontotemporal Dementia: A Systematic Review

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