Observation The Efficacy Of Donepezil Hydrochloride On Alzheimer Disease And Vascular Dementia

Background: Donepezil hydrochloride is a piperidine derivative of the reversible cholinesterase inhibitor.It could specifically inhibit the degradation of acetylcholine in the brain to increase choline level of the cerebral cortex. In the past,it was used for the treatment of Alzheimer disease. Recently, it also used for the treatment of vascular dementia at home and abroad. In several 12-to 24-week placebo-controlled trials of patients with mild to moderate probable AD (N=1759), subjects treated with a daily dose of donepezil,5mg to 10mg, demonstrated statistically significant favorable differences on the ADAS-Cog and CIBIC-plus. At the same time there are clinical trials of donepezil on patients with VD also may be useful. But there are not many reports on comparing the efficacy of donepezil on the two kind of dementia.Purpose:The aims of this study were to compare the efficacy of donepezil hydrochloride on AD and VD patients after taking the drugs for 12 weeks.In the study, Mini-mental state examination is the tool to analysis the situation of patients.Methods:Select patients with chief complaint of memory loss and continued more than three months at neurology outpatients of Qilu Hospital from May 2009 to Nov 2009. Inclusion criteria:1,Patients with cognitive impairment are confirmed by MMSE and in accordance with AD, VD diagnostic criteria; 2,They agree with and be able to insist on continuing to take donepezil hydrochloride for 12 wee-ks;3,They can return Qilu Hospital to review MMSE scale after 12 weeks. By the change of the MMSE scores before and after,we can analysis the drug's effectiveness.And we can analysis of the safety of the medicine by the adverse appeared in the process.Results:28 patients with cognitive disorders (VD:AD=17:11) were enrolled.Among them,2 VD patients'MMSE points was lower than before, which may be related to disease recurrence;3 AD patients' MMSE points didn't change;23 patients' MMSE points increased that compared with that before treatment.There was one case who felt discomfort of stomach,which dispeared after withdrawal.This symptoms didn't appear again when the patient continued treatment. By application of Statistical Methods,there were significant difference about MMSE points between pre- and after-treatment after treatment by donepezil hydrochlo-ride for 12 weeks.Moreover,this drug used for VD was more effective than that for AD.Conclusions:1. The memory and activity of daily living of Patients with cognitive disorders would be improved after taking donepezil hydrochloride for 12 weeks. So the efficacy of this drug was affirmed for Patients with cognitive disorders,and more effective in VD.2. There was only one case of adverse drug reactions,which disappeared after withdrawal.As a result, donepezil hydrochloride had good safety, and most of population can take this drug safely.