Donepezil medicated memory improvement in traumatic brain injury during post acute rehabilitation.
Memory dysfunction is a recognized and difficult to treat complication of traumatic brain injury (TBI). Since medial-temporal lobe injury is a frequent contributor to memory dysfunction in TBI, it is likely that an acetylcholine deficit contributes to memory dysfunction in this population. Recently, Donepezil, an acetylcholine-esterase inhibitor which has demonstrated a high selectivity for neural Ach-esterase (with minimal side effects), was approved for use in dementia in Alzheimer's patients. Due to its promising results in Alzheimer's patients, and reports in the literature describing the use of physostigmine (an anti-cholinesterase with significant cardiovascular and autonomic side effects) to treat memory deficits in closed head injury, we decided to begin a trial of Donepezil in two patients with TBI who were experiencing long term static memory dysfunction refractory to conventional treatment. Both patients were admitted to our facility for physical and cognitive rehabilitation, and were started on a trial of Donepezil. Modified memory tests and subjective observations by both family and staff pointed to an improvement in memory within three weeks of starting Donepezil. Should these initial results be supported in larger trials, Donepezil may prove to be a valuable tool for the treatment of memory dysfunction in TBI.
Taverni
J P
JP
Department of Internal Medicine and Neurology, Helen Hayes Hospital, West Haverstraw, New York 10993, USA.
Seliger
G
G
Lichtman
S W
SW
D000328:Adult; D000544:Alzheimer Disease / Q000188:drug therapy; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D000077265:Donepezil; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications / Q000534:rehabilitation; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008568:Memory / Q000187:drug effects*; D008569:Memory Disorders / Q000188:drug therapy* / Q000209:etiology; D011939:Mental Recall / Q000187:drug effects; D008875:Middle Aged; D026741:Physical Therapy Modalities; D010830:Physostigmine / Q000009:adverse effects / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use*; D013702:Temporal Lobe / Q000187:drug effects / Q000293:injuries
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil; D010830:Physostigmine