Share This Page

Support & Insight for the Autumn of Life

Cognitive Boost for Dementia with Lewy Bodies

Donepezil

GOOD NEWS: Donepezil (Aricept®), approved for Alzheimer’s, also passed a long-term trial for Dementia with Lewy Bodies (DLB). Get the details on the medicine’s positive results.


Dementia with Lewy bodies (DLB) is a common form of dementia in the elderly. It accounts for 10-15% of patients with dementia and constitutes the second largest group after Alzheimer’s disease.

These 3 dementia drugs are similar.
They are all cholinesterase inhibitors:
Brand Name Generic
Exelon rivastigmine
Aricept donepezil
Razadyne galantamine

Recent studies have shown that cholinesterase inhibitors like donepezil (Brand name: Aricept®) can help in the short term.

This study is the first to show how it can help over the long run.

Long-Term Results are Positive

The 108 patients with DLB who participated in this “extension study” were continuing on from an earlier, shorter 12-week clinical trial testing donepezil for DLB.

The latest results demonstrate that cognitive function and dementia-related behavioral symptoms, including cognitive fluctuations, were improved after the start of donepezil treatment, and maintained for 52 weeks. That is to say, an entire year of benefit was seen in this trial, and if the preceding 12-week period is included, an impressive 64 weeks of treatment efficacy was demonstrated.

The findings suggest that treatment efficacy of donepezil for these symptoms may be maintained for even longer than the 64 weeks of this trial. This is because no linear decrease in evaluation scores was observed.

DLB versus Alzheimer’s

Donepezil was originally FDA-approved for Alzheimer’s, for which there have been extensive trials. Therefore, a comparison of this DLB trial to similar Alzheimer’s trials reveals important insights.

The results indicate that cognitive decline in DLB may be faster than or at least similar to that in Alzheimer’s Disease (AD) patients. This implies that patients with DLB might be even more likely to benefit from donepezil treatment compared to Alzheimer’s patients.

As for caregivers, the donepezil treatment seemed to help them avoid the typical increase in burden that typically occurs with an untreated patient over such a long period of time. In other words, the medicine did not improve the situation for the caregiver; notwithstanding, it succeeded in keeping the situation from getting any worse.

Side Effects

Unsurprisingly, a relationship between the washout period and attenuation in the treatment effect was suggested. Among patients who were assigned to the donepezil treatment groups in the preceding RCT, cognitive function and behavioral/psychiatric symptoms deteriorated more in patients with a longer washout period. This could indicate that the treatment effect might eventually diminish if donepezil administration was stopped for a long period of time.

Since there was no significant imbalance in the AE incidence analyzed by onset time, it is therefore suggested that delayed onset of AE induced by long-term donepezil administration is unlikely to appear in these patients. Patients with DLB may be at increased risk of bradyarrhythmia resulting from treatment with ChEIs though [14]. In this long-term study, however, only 2 patients experienced abnormal changes in pulse rate (1 bradycardia and 1 sinus bradycardia), and neither of these were serious. Also, long-term administration of donepezil is unlikely to worsen parkinsonian symptoms since UPDRS scores did not worsen over 52 weeks. Furthermore, only 3 patients received dose reductions to 3 mg/day due to AEs. Two of them completed this study with the reduced dose, thereby enabling the patients to continue treatment with donepezil by reducing the dosage to 3 mg/day. In comparison to a study of donepezil in patients with AD, AEs reported in this study were similar to those reported in the study of AD patients, except for parkinsonism [20].

Conclusions

The results appear to reliably indicate the efficacy of donepezil as a worthwhile treatment for DLB.

In conclusion, the long-term administration of donepezil at 5 mg/day was safe in patients with DLB, and is expected to exhibit lasting effects on improving impaired cognitive function and psychiatric symptoms.

Email me when people comment
Notify of
guest

This site uses Akismet to reduce spam. Learn how your comment data is processed.

6 Comments
Inline Feedbacks
View all comments
Unknown
Unknown
May 20, 2015 3:45 pm

This comment has been removed by the author.

pauley
pauley
January 6, 2016 8:50 pm

wife taken off donepezil due to her heart slowing,it was good now on risperidone not so effective.

Unknown
Unknown
January 7, 2016 3:44 am

About Dementia with Lewy Bodies,as a support therapy,researchers could study deeper the nutraceutical CARNOSINE,that is a heavy metal chelator,a peroxinitrites scavenger and anti-glycating agent,in small doses(only under physician prescription)has synergistic effects with ALCAR.And CARNOSINE,has the potential to lowers betamyloid accumulation in Alzheimer disease(1),lowers alpha-synuclein accumulation in Parkinson disease and in Dementia of Lewy Bodies(2),(3)and lowers the prion-like spreads(4)that happens inside the brain of AD,PD and DLB patients.Based in:1)"Anti-aggregating Effect of the Naturally Occurring Dipeptide Carnosine on Betamyloid Fibril Formation" 2013PLoS);2)"Antioxidative and Anti-inflammatory Protection From Carnosine in the Striatum of Treated Mice"(2010,J Agric Food Chem.);3)"Enhanced Oligomerization of the Alpha-Synuclein Mutant by the Copper,Zinc Superoxide Dismutase and Hydrogen Peroxide System"(2003,Molecules and Cells);4)"Zinc,Copper,and Carnosine Attenuate Neurotoxicity of Prion Fragment"Metallomics 2011)

Unknown
Unknown
January 7, 2016 3:53 am

In the research article with the title,"Effects of Acetyl-L-Carnitine In Alzheimer's Disease Patients Unresponsive to Acetylcholinesterase Inhibitor",by Bianchetti and colleagues,in the journal Current Medical Research,in 2003,we can read that ACETYL L CARNITINE(so called ALCAR)INCREASED IN FIFTY PERCENT THE EFFECTIVINESS OF DONEPEZIL(and of others acetylcholinesterase inhibitors too)when they gave donepezil together with ALCAR(only in small doses,under physician prescription).The authors concluded:"The association of Donepezil to ALCAR indicates that the combination of these two drugs may be a useful therapeutic option in AD patient".We can find the article searching in Google by it title above.

Unknown
Unknown
January 7, 2016 4:14 am

About Dementia with Lewy Bodies,as a support therapy,researchers could study deeper the nutraceutical CARNOSINE,that is a heavy metal chelator,a peroxinitrites scavenger and anti-glycating agent,in small doses(only under physician prescription)has synergistic effects with ALCAR.And CARNOSINE,has the potential to lowers betamyloid accumulation in Alzheimer disease(1),lowers alpha-synuclein accumulation in Parkinson disease and in Dementia of Lewy Bodies(2),(3)and lowers the prion-like spreads(4)that happens inside the brain of AD,PD and DLB patients.Based in:1)"Anti-aggregating Effect of the Naturally Occurring Dipeptide Carnosine on Betamyloid Fibril Formation" 2013PLoS);2)"Antioxidative and Anti-inflammatory Protection From Carnosine in the Striatum of Treated Mice"(2010,J Agric Food Chem.);3)"Enhanced Oligomerization of the Alpha-Synuclein Mutant by the Copper,Zinc Superoxide Dismutase and Hydrogen Peroxide System"(2003,Molecules and Cells);4)"Zinc,Copper,and Carnosine Attenuate Neurotoxicity of Prion Fragment"Metallomics 2011)

JezMyOpinion
JezMyOpinion
December 9, 2022 12:30 pm

Just started Donepezil last week 12/01/22. Wish me luck!

Edited by:
Picture of P. Berger

P. Berger

This site was inspired by my Mom’s autoimmune dementia.

It is a place where we separate out the wheat from the chafe, the important articles & videos from each week’s river of news. Google gets a new post on Alzheimer’s or dementia every 7 minutes. That can overwhelm anyone looking for help. This site filters out, focuses on and offers only the best information. it has helped hundreds of thousands of people since it debuted in 2007. Thanks to our many subscribers for your supportive feedback.

The site is dedicated to all those preserving the dignity of the community of people living with dementia.

Peter Berger, Editor

Share this page To

Related:

Prevention

Cynicism Triples Dementia Risk?

In a study on health & cynicism, people were asked how much they agree with statements such as, “I think most people would lie to get ahead,” and “It is safer to trust nobody”. The clear connection between their answers and their risk of dementia may startle you.

Read More »
Share to Facebook
Twitter
LinkedIn

This site was inspired by my Mom’s autoimmune dementia.

It is a place where we separate out the wheat from the chafe, the important articles & videos from each week’s river of news. Google gets a new post on Alzheimer’s or dementia every 7 minutes. That can overwhelm anyone looking for help. This site filters out, focuses on and offers only the best information. it has helped hundreds of thousands of people since it debuted in 2007. Thanks to our many subscribers for your supportive feedback.

The site is dedicated to all those preserving the dignity of the community of people living with dementia.

Peter Berger, Editor

Visit Alzheimer's Weekly On

6
0
Would love your thoughts, please comment.x
()
x
News, Treatments, Care Tips, Diet

Alzheimer's & Dementia Weekly Newsletter: Free

Free. Care & Treatment. Research & Prevention

This site was inspired by my Mom’s autoimmune dementia.

It is a place where we separate out the wheat from the chafe, the important articles & videos from each week’s river of news. Google gets a new post on Alzheimer’s or dementia every 7 minutes. That can overwhelm anyone looking for help. This site filters out, focuses on and offers only the best information. It has helped hundreds of thousands of people since it debuted in 2007. Thanks to our many subscribers for your supportive feedback.

The site is dedicated to all those preserving the dignity of the community of people living with dementia.

Peter Berger, Editor

News to Get at the Truth

Subscribe To Our Weekly Newsletter