Donepezil in the treatment of patients with Alzheimer's disease

Donepezil is the most widely used acetylcholinesterase inhibitor licensed for symptomatic treatment of mild-to-moderate Alzheimer's disease. Clinical placebo-controlled trials and open-label extension studies have consistently shown that donepezil is well tolerated and gives rise to statistically significant improvements in cognition, global function and activities of daily living for at least 12 months and to less deterioration of function possibly for more than 4 years. Furthermore, donepezil may reduce neuropsychiatric symptoms and caregiver burden. Health economic studies suggest that treatment with donepezil may reduce resource utilization. Evidence-based international management guidelines recommend that treatment with a cholinesterase inhibitor should be considered in all patients with mild-to-moderate Alzheimer's disease and based on a proper diagnostic evaluation. Treatment cannot replace continuous advice to patients and caregivers.