Donepezil for memory dysfunction in schizophrenia

Howard, Andrew; Thornton, Allen E.; Altman, Siemion; Honer, William G.

doi:10.1177/026988110201600313

Cited by 20 publications

(15 citation statements)

References 23 publications

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“…This is in concordance with other reports in which donepezil did not improve psychotic symptomatology in schizophrenia patients (Risch et al, 2001;Buchanan et al, 2002;Friedman et al, 2002;Howard et al, 2002;Stryjer, 2002Stryjer, , 2003. Recent evidence suggests that muscarinic/cholinergic inhibition of brain dopaminergic activity may be a useful principle in the development of novel antipsychotic medication (Ichikawa et al, 2002a).…”

Section: Discussionsupporting

confidence: 92%

“…This may in turn be alleviated by increasing cholinergic activity at muscarinic and nicotinic receptors (Karson et al, 1996;Crook et al, 2000;Freedman et al, 1995;Leonard et al, 1996). To date there are four reports on the beneficial effect of donepezil on cognitive dysfunction in schizophrenia (Risch et al, 2001;Buchanan et al, 2002;Friedman et al, 2002;Howard et al, 2002) and two reports (Stryjer et al, 2002(Stryjer et al, , 2003 of the beneficial effect of donepezil in schizophrenia with comorbid dementia. It is important to note that none of these reports have demonstrated any efficacy of donepezil on the management of psychotic symptoms in schizophrenia patients.…”

Section: Introductionmentioning

confidence: 99%

“…It is important to note that none of these reports have demonstrated any efficacy of donepezil on the management of psychotic symptoms in schizophrenia patients. Despite the apparent lack of evidence indicating any beneficial effect of donepezil in the improvement of psychotic symptomatology in schizophrenia patients (Risch et al, 2001;Buchanan et al, 2002;Friedman et al, 2002;Howard et al, 2002;Stryjer, 2002Stryjer, , 2003, in this study the intention was to determine for the first time whether donepezil augmentation of clozapine monotherapy in schizophrenia patients would improve psychotic symptomatology.…”

Section: Introductionmentioning

confidence: 99%

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Donepezil augmentation of clozapine monotherapy in schizophrenia patients: a double blind cross‐over study

Stryjer¹,

Strous

Bar

et al. 2004

Human Psychopharmacology

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Increasing evidence suggests that the cholinergic system is involved in the pathogenesis of schizophrenia. Donepezil, a central cholinesterase inhibitor, improves psychotic symptomatology in demented patients, however, evidence for its role in the management of active psychosis in schizophrenia remains limited. An 18-week double blind cross-over study was conducted in which eight patients were randomly assigned to either donepezil (5 mg/day for the first 4 weeks and 10 mg/day for the following 4 weeks) or placebo as augmentation treatment to clozapine. After this initial phase, there was a 2-week washout period of the study medication after which the same regimen was crossed over at the same dose and for the same period (8 weeks). No significant difference was noted in the total positive and negative symptom scale scores when donepezil was compared with placebo (16.7%+12.97% vs 3.20%+13.94% respectively, p = 0.18). However, three patients improved (>15%) in the total PANSS scores (37.03%, 16.6% and 25.33%) during the donepezil treatment phase, while only one patient improved (20.87%) during the placebo phase. No differences were noted in the Calgary depression scale (p = 0.305), Simpson Angus scale (p = 0.374), clinical global impression-improvement scale (p = 0.23) and clinical global impression-severity of illness scores (p = 0.116). Although this preliminary study failed to demonstrate a clear effect of donepezil augmentation in clozapine treated chronic schizophrenia patients, it seems that the subtle positive effect of donepezil observed in some of our patients should encourage further investigation in a larger sample of this patient subpopulation.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Donepezil augmentation of clozapine monotherapy in schizophrenia patients: a double blind cross‐over study

Stryjer¹,

Strous

Bar

et al. 2004

Human Psychopharmacology

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“…[314][315][316] However, a recent double-blind controlled trial of donepezil added to risperidone did not show any positive effects on cognitive deficit associated with schizophrenia. 317 Treatments for schizophrenia S Miyamoto et al Muscarinic receptor agonist There is a large body of anatomical and pharmacological evidence for potential modulation of dopamine and glutamatergic neurons by cholinergic muscarinic receptors (for a review, see Bymaster 318 ).…”

Section: Noradrenergic Agentsmentioning

confidence: 98%

Treatments for schizophrenia: a critical review of pharmacology and mechanisms of action of antipsychotic drugs

et al. 2004

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The treatment of schizophrenia has evolved over the past half century primarily in the context of antipsychotic drug development. Although there has been significant progress resulting in the availability and use of numerous medications, these reflect three basic classes of medications (conventional (typical), atypical and dopamine partial agonist antipsychotics) all of which, despite working by varying mechanisms of actions, act principally on dopamine systems. Many of the second-generation (atypical and dopamine partial agonist) antipsychotics are believed to offer advantages over first-generation agents in the treatment for schizophrenia. However, the pharmacological properties that confer the different therapeutic effects of the new generation of antipsychotic drugs have remained elusive, and certain side effects can still impact patient health and quality of life. Moreover, the efficacy of antipsychotic drugs is limited prompting the clinical use of adjunctive pharmacy to augment the effects of treatment. In addition, the search for novel and nondopaminergic antipsychotic drugs has not been successful to date, though numerous development strategies continue to be pursued, guided by various pathophysiologic hypotheses. This article provides a brief review and critique of the current therapeutic armamentarium for treating schizophrenia and drug development strategies and theories of mechanisms of action of antipsychotics, and focuses on novel targets for therapeutic agents for future drug development.

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“…Donepezil (Aricept™, Eisai Co. Ltd, Tokyo, Japan) is a newer AChE-inhibitor also mainly used for treating dementia. Howard and colleagues describe a slight improvement of cognitive functions, impaired by psychosis [27]. A possible efficacy for treating cognitive impairment caused by other reasons, such as attention deficit hyperactivity disorder or autism was suggested.…”

Section: Ache-inhibitors and Autismmentioning

confidence: 99%

Acetylcholinesterase-inhibitors in the treatment of autistic disorders

Niederhofer¹

2003

Expert Review of Neurotherapeutics

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Donepezil for memory dysfunction in schizophrenia

Abstract: A case is reported of a 54-year-old female patient with schizophrenia and cognitive impairment. Her memory dysfunction improved following the addition of donepezil to quetiapine. The possible implications for future studies are reviewed.

Cited by 20 publications

References 23 publications

Donepezil augmentation of clozapine monotherapy in schizophrenia patients: a double blind cross‐over study

Donepezil augmentation of clozapine monotherapy in schizophrenia patients: a double blind cross‐over study

Treatments for schizophrenia: a critical review of pharmacology and mechanisms of action of antipsychotic drugs

Acetylcholinesterase-inhibitors in the treatment of autistic disorders

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