aricept, Pimavanserin

How Does Aricept Work for Alzheimer’s?

By | February 16th, 2018

Learn from an expert about how does Aricept work in the brain and its side effects for patients with dementia and Alzheimer's disease.

While there is currently no treatment for Alzheimer’s disease, a drug called Aricept can temporarily ease the symptoms for a short period of time. Aricept, also known as Donezepil, does not slow down the progression of the disease in the brain, but it can slow down further decline in cognition, usually for around six months.

Aricept was the second drug approved for Alzheimer’s, after Cognex, a similar drug, but one with more side effects. It was approved in November 1996, and was ranked the most effective in a recent study. However, it was also ranked as the drug with the most side effects, like vomiting and nausea.

Aricept is also known as Donepezil hydrochloride, Eranz and E 2020. It is approved to treat Alzheimer’s disease, dementia with Lewy bodies, Down syndrome and Parkinson’s disease.

How does Aricept/Donezepil work?

Aricept is an oral medication taken once daily that stops the breakdown of acetylcholine, a brain chemical that helps nerve cells communicate with one another. It’s part of a class of drugs known as cholinesterase inhibitors.

What can I expect?

The effects of Aricept are limited. “Some people may feel better,” said Dr. Lon Schneider, M.D., professor of psychiatry, neurology and gerontology at the Keck School of Medicine at University of Southern California. “They or a caregiver might see that they seem more attentive or interactive or engaged. Most others may not notice much,” he said. Schneider said the benefits of Aricept are small, but should not be discounted entirely. In studies, effectiveness has been gauged by patients scoring a few points better on tests of immediate memory and orientation—things like knowing what the date is, or having a slightly better sense of direction, said Schneider. But that doesn’t always translate to improvements outside of a clinical setting. “Sometimes these aren’t noticeable in day-to-day living,” said Schneider. “If a person is taking medication and is not sure that they’re benefiting, but not being hurt, either, we generally recommend people take the medication. If you want to stop, it’s OK to taper over a couple of months and see how you do without it.”

What is the evidence that Aricept works?

-A 24-week study showed that patients who took Aricept showed significant improvement when compared to a control group that took a placebo. When they patients were taken off Aricept, improvements dropped off, showing that Aricept may treat the symptoms of Alzheimer’s, but not the underlying disease itself.

-In 2006, Aricept was approved to treat severe Alzheimer’s in the United States, along with moderate and mild Alzheimer’s, after a study showed benefits for everyday living activities. It is not approved for severe Alzheimer’s in Europe.

-Long-term treatment with donepezil was shown to delay nursing home placement for Alzheimer’s patients.

-However, a British study published in 2004 suggested that Aricept has “disappointingly little overall benefit,” and is not worth the cost. That study followed patients taking Aricept for three years, comparing them to a group who did not take the drug. Although the Aricept group scored slightly higher on cognitive tests, they did not differ from the control group after three years in terms of nursing home placement rates or becoming disabled.

Does Aricept work for everyone?

Some patients do not see improvement with Aricept.

Does it work right away?

“Many people may experience an improvement after a few weeks or a few months,” said Schneider.

How long does Aricept work for?

While Aricept does offer improvement for some patients, the effects are not long-term. “We can measure that after six months, people are a tiny bit better,” said Schneider. “Over time the progression is not changed.” Schneider says that most patients do not stay on Aricept throughout the course of their disease. “Only a minority of patients stay on the medication over a long period of time. Many do not feel it’s helpful,” he said.

Are Donepezil and Aricept the same?

Yes. Aricept is the brand-name drug for donepezil.

What is the best time of day to take Aricept?

Doctors recommend taking Aricept at night.

Why does Aricept have to be taken at night?

Aricept is taken at night because it can cause irregular or slow heartbeat for some patients, which can cause fainting. When it is taken at bedtime, patients are able to sleep through those side effects.

Is Aricept effective for dementia?

According to the FDA, Aricept is only approved to relieve symptoms of some dementias, and does not halt or reverse it.

What are the side effects of Aricept?

Patients report nausea, fainting and uncomfortable urinary retention. Doctors recommend the pill be taken whole; splitting or crushing the tablet can increase side effects. If a patient stops taking Aricept for more than seven days, talk to the patient’s doctor about starting back up on a lower dose. Starting on a full dose again after not taking it could increase side effects.



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34 thoughts on “How Does Aricept Work for Alzheimer’s?

    1. Did it work at all? My son-in-law is on it for the same condition and hasn’t seen any
      improvement yet, been a couple months or so.

  1. If my 70 year old husband already has a resting heart rate of 48, would it be wise to start Aracept, since a significant side effect is lowering the heart rate?

    1. As the norm is taking it a night, someone should just sleep through any side effects. Only a doctor should decide if this is the right drug and dose.

      1. What do you do when two doctors have two different opinions one a neurologist and the other family doctor. One says to take it every day, the other say to take a needed ( only when agitated )

        1. My husband is taking 10mg twice a day and he is taking for a brain fog after surgery he had. It worked but now he needs to stop it how should he do it? He is 82 yr old.

          1. Hello Pattie, Consult Your Physician – Being Patient does not give medical advice, nor is any information on the site intended to be prescriptive medical advice. If you have any questions about your health or the health of your loved one, please consult your physician for any and all medical-related questions. ~ Thank you.

    2. My relative, 79, hospitalized for a broken cervical vertebrae, became delirious when his Aricept 10 mg wasn’t administered for two days. When it was resumed, delusions stopped within hours. Two days later, the medication was again stopped because of swallowing problems and delusions reappeared within 48 hours. As his health care power of attorney I insisted Aricept be dissolved on his tongue or in an ice chip worth of water and he swallowed it with no problem. Within hours, hallucinations again subsided. A physician might conclude that because Aricept’s elimination half-life is three days that it wouldn’t hurt to discontinue it for a few days, but my relative, who has been flourishing on Aricept for two years, is sensitive to even a brief cessation of it. It’s worth being familiar with various ways a drug can be administered and side effects if it is discontinued.

  2. I am 73 years of age and a very fit female. I have been diagnosed with early stage Alzheimer’s and have been on Donepezil 5mg for a week. My head feels very heavy I feel dizzy at times. Will this lease with time taking this drip. Regards Joy Mclaughlin

    1. I have been on Aricept for about 5 weeks. I am 74.5 years old. I awake feeling tired and have some disturbing or grueling type dreams. If I take it during the day I feel slightly speedy and pressured but get a lot of things done. My heart beats harder. I have MCI and positive signs on an MRI. What do you recommend? Is studying a foreign language and exercising enough without med. Some advice about what you know and don’t know. Thanks.

      1. I think studying a foreign language is too time consuming for our age. Use the time to enjoy whatever life we have left. Eva

    2. Joy – My wife started taking it at 63 and is now 67. She takes it at bedtime and I have not detected any side affects. I honestly think it has slowed the progression. Blessings to you and your family.

  3. I am having sleep issues from Donepezil . I have no problem falling to sleep but usually get about 4 hrs. Then I am wide awake all remaining night. I have seen some improvement from Donepesil but nothing major. Is it possible to take at a different time or maybe split pill into noon & bedtime? How long is it Ok to take this medicine?

    1. Hi Audrey,
      Always contact your doctor to see what medications you should take. We do not provide this type of information. So sorry!
      The Being Patient Team

    2. My wife started it at 63 and is now 67. She takes it at bedtime along with an over the counter sleep aid. She can sleep 8 hours straight with no side effects. I think it has slowed the progression.

  4. I have been living with MCI for many years (born in 1948) and it seems to help but I am now retired and my Boss where I worked when I told him of my diagnosis said that he noticed short term memory loss but wasn’t sure what was going on?

  5. My husband was diagnosed by our Gp with onset dementia in March 2018. Our Gp prescribed Prozac 20 which he took for 3 months. At the start of the fourth month we consulted with a psychiatrist, whom put him on Donecept 5ml for thirst month and after the first month upped it to 10ml. It is now +- 12 months on and still on Donecept 10ml and he is functioning quite normal….working again no real signs of dementia. Could he have misdiagnosed? Could it just have been severe depression. He was under severe strain having lost his business and our home in the process for a couple of years prior to be diagnosed with onset dementia.

    1. Hi Charlotte I’m going threw the same with my husband not knowing g if it’s severe depression or really a start of memory loss . Ur story is helpful seeing I was so against starting this medication due to do many saying it worsened the patient and the side effects it has . You actually see good results ? I

    1. Hello Bob, a combination of a lumbar puncture (spinal tap) to test for the toxic TAU protein and a beta-amyloid PET scan to show the plaque build-up are rather conclusive. ~ Thank you

  6. My husband was recently told he may have late onset altheizmers based on a 30 point written test. He scored about 16 out of 30, hence the dr stating what he believed.. that being said, I really feel like my husband would have done much better on the test if he wasnt so full of anxiety, he is also a self doubter bigggg time and I think maybe that was the cause for concern. Well, he is now taking aricept 5 mg. I wan to also try COGNIUM. Anyone also taking a supplement or additional help? TIA!

    1. Hello Lisa, Consult Your Physician – Being Patient does not give medical advice, nor is any information on the site intended to be prescriptive medical advice. If you have any questions about your health or the health of your loved one, please consult your physician for any and all medical-related questions. ~ Thank you.

  7. Iam a 51 year old white male I was diagnosed with a mild cognitive disorder when I was 49. I started out on 5 mg of the Donepezil it seem to work for a few weeks then it seem liked it stopped working . Now Iam on 10 mg I have taken this medication now for about 19 months it has made a big Difference in Quality of life. Side effects can be mild I can tell when it is waring off I am lost for word at times and can not think correctly.and understand simple instructions I high recommend this medication.

  8. I’m a 73 year old male who is experiencing some cognjtive dissonance. I,ve learned that my blood rate is jn the low 50,s. How does that effect Arrcept use?

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