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Role of Donepezil in the Management of Neuropsychiatric Symptoms in Alzheimer's Disease and Dementia with Lewy Bodies
Authors:Jeffrey Cummings  Te‐Jen Lai  Solaphat Hemrungrojn  E Mohandas  Sang Yun Kim  Girish Nair  Amitabh Dash
Institution:1. Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA;2. Department of Psychiatry, Chung Shan Medical University Hospital, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan;3. Department of Psychiatry, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;4. Department of Psychological Medicine, Sun Medical and Research Centre, Thrissur, Kerala, India;5. Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, Korea;6. Department of Neurology, Fortis Hospital Mahim, Mumbai, India;7. Eisai Co. Ltd., Mumbai, India
Abstract:Alzheimer's disease (AD) is a progressive condition that affects cognition, function, and behavior. Approximately 60–90% of patients with AD develop neuropsychiatric symptoms (NPS) such as hallucinations, delusions, agitation/aggression, dysphoria/depression, anxiety, irritability, disinhibition, euphoria, apathy, aberrant motor behavior, sleep disturbances, appetite and eating changes, or altered sexual behavior. These noncognitive behavior changes are thought to result from anatomical and biochemical changes within the brain, and have been linked, in part, to cholinergic deficiency. Cholinesterase inhibitors may reduce the emergence of NPS and have a role in their treatment. These agents may delay initiation of, or reduce the need for, other drugs such as antipsychotics. This article summarizes the effects of donepezil, a cholinesterase inhibitor, on the NPS of dementia with emphasis on AD and dementia with Lewy bodies.
Keywords:Alzheimer disease  Behavioral symptoms  Cholinesterase inhibitors  Dementia  Donepezil
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