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.