Several studies have reported the efficacy of donepezil (a cholinesterase inhibitor) in patients with Alzheimer's Disease, not only for memory disturbances but also for psychotic and behavioral disturbances.
We have experienced one such case that was a 74-year-old female patient with Alzheimer's Disease. Donepezil remarkably improved, for the most part, these symptoms in this case.
The scale of Mini-Mental State Examination (MMSE) was improved from 21/30 to 26/30, and the Alzheimer's Disease Assessment Scale (ADAS) was improved from 21.7/70 to 16.3/70. It took about 8 weeks of treatment with donepezil to achieve these results, although some adverse effects associated with the use of donepezil were found in this case. It became difficult for the nursing staff to give care because of hyperactivity and self-assertion.
However, the relationship between donepezil and these behavioral disturbances was not clear.
This case indicates that donepezil may exacerbate symptoms in Alzheimer's Disease patients who have psychotic and behavioral problems.
From a clinical point of view, we concluded that donepezil is therapeutically efficacious for Alzheimer's Disease sufferers, but that some problems still exist.