QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in The Annals Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kondoh, T. Articles by Moriuchi, H. Search for Related Content PubMed PubMed Citation Articles by Kondoh, T. Articles by Moriuchi, H.

Dramatic Improvement in Down Syndrome–Associated Cognitive Impairment with Donepezil

Associate Professor, Department of Pediatrics, Nagasaki University Hospital, Nagasaki, Japan

Nagisa Amamoto, MD

Senior Medical Resident, Department of Pediatrics, Nagasaki University Hospital

Tomoki Doi, MD

Senior Medical Resident, Department of Pediatrics, Nagasaki University Hospital

Hitomi Hamada, MD

Senior Medical Resident, Department of Pediatrics, Nagasaki University Hospital

Yoji Ogawa, MD PhD

Assistant Professor, Department of Radiology, Nagasaki University Hospital

Mikiro Nakashima, PharmD

Associate Professor, Department of Hospital Pharmacy, Nagasaki University Hospital

Hitoshi Sasaki, PharmD

Professor and Head, Department of Hospital Pharmacy, Nagasaki University Hospital

Katsuyo Aikawa, MD PhD

Professor and Principal, School for the Mentally Retarded, Faculty of Education, Nagasaki University, Nagasaki

Tatsuhiko Tanaka, MA

Principal, Kakunan School for the Handicapped, Nagasaki

Mizue Aoki, MA

Assistant Principal, School for the Mentally Retarded, Faculty of Education, Nagasaki University

Junji Harada, MA

Professor, Faculty of Education, Nagasaki University

Hiroyuki Moriuchi, MD PhD

Professor and Head, Department of Pediatrics, Nagasaki University School of Medicine

Reprints: Dr. Kondoh, Department of Pediatrics, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki 852-8501, Japan, fax 81-95-849-7301, kontatsu{at}net.nagasaki-u.ac.jp

OBJECTIVE: To report 2 cases of patients with Down syndrome and severe cognitive impairment who gained dramatic improvements in quality of life (QOL) upon donepezil treatment.

CASE SUMMARIES: Case 1. A 38-year-old woman with Down syndrome, diagnosed with secondary progressive dementia when her mental state had deteriorated rapidly after graduation from junior high school, started donepezil treatment. The loading dose was 3 mg/day and was increased to 5 mg/day for maintenance. One month after the dose was increased, adverse effects such as soft stool and urinary incontinence appeared. These adverse effects disappeared when the dose was decreased again to 3 mg/day. Her QOL improved dramatically with this minimal dose. She recovered verbal and written communication skills that she had lost for the past 21 years. Case 2. A 22-year-old man with Down syndrome, who had been diagnosed as having severe mental retardation, was put on donepezil therapy. Both loading and maintenance doses were 3 mg/day. His QOL had also dramatically improved, with some recovery in verbal communication. Transient agitation/violence and transient muscle weakness appeared during the first few months of treatment.

DISCUSSION: Patients with Down syndrome may be more sensitive to donepezil therapy than others and may benefit from this medicine, although they may also have adverse effects more frequently.

CONCLUSIONS: Donepezil may be a useful medicine for some patients with Down syndrome with severe cognitive impairment or mental retardation if the adverse effects are manageable.

Key Words: donepezil, Down syndrome, quality of life

Published Online, February 8, 2005. www.theannals.com, DOI 10.1345/aph.1E427

Related articles in The Annals:

Pharmacokinetics of donepezil in Down syndrome

Tatsuro Kondoh, Mikiro Nakashima, Hitoshi Sasaki, and Hiroyuki Moriuchi
The Annals 2005 39: 572-573. [Full Text]  

This article has been cited by other articles:

				V. Fodale, F. Mafrica, V. Caminiti, and G. Grasso The cholinergic system in Down's syndrome. J Intellect Disabil., September 1, 2006; 10(3): 261 - 274. [Abstract] [PDF]