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Cholinesterase inhibitors in advanced Dementia with Lewy bodies: increase or stop?

Lookup NU author(s): Dr Sanjeet Pakrasi, Professor Alan ThomasORCiD, Dr Urs Mosimann, Dr David Cousins, Debbie LettORCiD, Professor David Burn, Professor John O'Brien, Professor Ian McKeith


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Introduction There is little data on stopping cholinesterase inhibitors in Dementia with Lewy bodies (DLB). Equally, it is not known if increasing the dose of cholinesterase inhibitors may help neuropsychiatric symptoms in advanced DLB. Method We conducted an open label trial with donepezil involving 16 patients with LBD when the dose was reduced and treatment stopped over 4 weeks. Another 7 patients were given a trial of an increased dose of donepezil (15 mg) to resolve reemergent neuropsychiatric symptoms. Results The slow discontinuation protocol was well tolerated in advanced DLB. Five of the seven patients given a trial of a higher dose of donepezil were rated as clinically improved after 12 weeks treatment. Conclusion Cholinesterase inhibitors can be discontinued slowly in advanced DLB. Increasing the dose of donepezil may be of benefit to some patients with DLB who experience a recurrence in their neuropsychiatric symptoms. Copyright (c) 2006 John Wiley & Sons, Ltd.

Publication metadata

Author(s): Pakrasi S, Thomas A, Mosimann UP, Cousins DA, Lett D, Burn DJ, O'Brien JT, McKeith IG

Publication type: Article

Publication status: Published

Journal: International Journal of Geriatric Psychiatry

Year: 2006

Volume: 21

Issue: 8

Pages: 719-721

ISSN (print): 0885-6230

ISSN (electronic): 1099-1166

Publisher: John Wiley & Sons Ltd.


DOI: 10.1002/gps.1547


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Funder referenceFunder name
G0400074Medical Research Council
G0502157Medical Research Council