Donepezil (Aricept)

Other names: Aricept

Donepezil is a drug used in the treatment of Alzheimer's disease. It has been studied as a treatment for impaired memory in people with cognitive symptoms due to multiple sclerosis.

A small study followed 69 people with MS taking either donepezil or a placebo for 24 weeks. It found that twice as many people in the treatment group reported memory improvement (65.7%) than those on placebo (32.4%). Health professionals also reported that more people in the treatment group showed improved cognitive symptoms. However, a larger study involving 120 people with MS showed no difference in improving memory between donepezil and placebo. More gastrointestinal side effects are seen with this type of medication than with a placebo.

A group in Iran have also looked at the effects of donepezil on cognitive impairment, quality of life and depression in MS. 100 patients with MS were divided into two groups, half took 10mg donepezil daily for three months whilst the other half received placebo. They concluded that donepezil could effectively improve cognitive issues and also had a positive effect on quality of life and depression.

However, a second study by the same group compared the benefits of donepezil against cognitive rehabilitation on memory, attention, quality of life and depression in MS. Although they found that both donepezil and cognitive rehabilitation had a positive effect on all four areas evaluated, cognitive rehabilitation was shown to be a more effective treatment than donepezil.

Because there have been limited trials of donepezil in MS and the results have been mixed, the current evidence of the efficacy of donepezil on cognitive function in people with MS is unclear.

How donepezil works

Donepezil is a cholinesterase inhibitor. It is thought to work by inhibiting an enzyme which breaks down acetylcholine, which is a chemical in the central nervous system that acts as a neurotransmitter - carrying messages from nerve to nerve. Therefore, donepezil increases levels of acetylcholine.

How do I take donepezil?

Donepezil is taken orally as tablets.

Side effects and contraindications

Donepezil is generally well tolerated with no serious side effects observed during the studies other than reports of unusual dreams.

Find out more

Christodoulou C, et al.
Effects of donepezil on memory and cognition in multiple sclerosis.
Journal of Neurological Sciences 2006;245(1-2):127-136.
Summary (link is external)
Krupp LB, et al.
Multicenter randomized clinical trial of donepezil for memory impairment in multiple sclerosis.
Neurology 2011;76(17):1500-1507.
Full article (link is external)
Li Y, et al.
Cholinesterase inhibitors for rarer dementias associated with neurological conditions.
Cochrane Database of Systematic Reviews 2015 Mar 3(3):CD009444.
Summary (link is external)
Shahpouri MM, et al.
Effect of donepezil on cognitive impairment, quality of life, and depression in multiple sclerosis patients: a randomized clinical trial.
International Journal of Preventative Medicine 2020;11:69.
Full article (link is external)
Shahpouri MM, et al.
Comparison of cognitive rehabilitation versus donepezil therapy on memory performance, attention, quality of life, and depression among multiple sclerosis patients.
Neurology Research International 2020;2020:8874424.
Full article (link is external)
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