Pharmaceutical

Donepezil

(RS)-2-[(1-Benzylpiperidin-4-yl)methyl]-5,6-dimethoxy-2,3-dihydro-1H-inden-1-one

Evidence TierAWADA NOT PROHIBITED

tuneTypical Dose

5-10

watchEffect Window

12-24 weeks to establish baseline efficacy improvements.

check_circleCompliance

WADA NOT PROHIBITED

Overview

Clinical Summary

Donepezil is a prescription acetylcholinesterase inhibitor used in Alzheimer’s disease. It is used to modestly improve cognitive symptoms and daily functioning by increasing cholinergic signaling.

Controlled trials show modest improvements or slower decline in cognition and activities of daily living in Alzheimer’s disease and some dementias. Benefits are symptomatic rather than disease modifying and vary by baseline severity. Minority studies examine mild cognitive impairment with inconsistent results. Side effects can limit tolerability, and outcomes depend on diagnosis and adherence.

Specific, reversible inhibitor of acetylcholinesterase (AChE) that enhances cholinergic transmission by preventing acetylcholine breakdown.

Outcomes

What This Is Expected To Influence

Primary Outcomes

  • Modest improvement in cognitive function and daily living activities in Alzheimer's disease.

Secondary Outcomes

  • No significant benefit demonstrated for Mild Cognitive Impairment prevention or healthy adult enhancement.

Safety

Contraindications and Interactions

Contraindications

  • Sick sinus syndrome
  • AV block
  • Active peptic ulcer
  • Severe asthma/COPD

Side effects

  • Nausea
  • Diarrhea
  • Insomnia
  • Vivid dreams
  • Muscle cramps
  • Fatigue
  • Loss of appetite

Interactions

  • Anticholinergics
  • NSAIDs
  • Beta-blockers
  • Succinylcholine

Avoid if

  • Healthy adult seeking nootropic use
  • Sick sinus syndrome
  • Active peptic ulcer

Evidence

Study-level References

donepezil-SRC-001Meta-analysis of RCTs
Sourceopen_in_new

Birks JS, Harvey RJ. "Donepezil for dementia due to Alzheimer's disease." Cochrane Database Syst Rev. 2018.

Population: Alzheimer's patients

Key findings: Patients on donepezil experienced benefits in cognitive function, activities of daily living, and clinician's global assessment. The 10 mg/day dose provided marginally better cognitive outcomes than 5 mg/day but with more adverse events.

Paper content

Patients on donepezil experienced benefits in cognitive function, activities of daily living, and clinician's global assessment. The 10 mg/day dose provided marginally better cognitive outcomes than 5 mg/day but with more adverse events.

Guides

Setup

Help