Adverse effects associated with the use of donepezil in general practice in England.
Donepezil is an acetylcholinesterase inhibitor indicated for the symptomatic treatment of mild to moderate Alzheimer's disease. It is reported to have a relatively favourable side-effect profile. We report here on a pharmacovigilance study carried out post-marketing in England. An observational cohort study using the technique of Prescription-Event Monitoring was carried out. Some 1762 patients (mean age 72.9 years; 42% male) were followed up for 6 months minimum. The commonest adverse events were nausea, diarrhoea, malaise, dizziness and insomnia. Aggression, agitation and abnormal dreams were uncommonly associated with the drug. There were no cardiac rhythm disturbances or liver disorders causally associated. The commonest adverse drug reactions are already reported in the product information. Given the relatively small size of this cohort, the signals of abnormal dreams and psychiatric disturbance as possible adverse drug reactions need further investigation in carefully planned studies.
Dunn
N R
NR
Drug Safety Research Unit, Bursledon Hall, Southampton, UK. nick.dunn@soton.ac.uk
Pearce
G L
GL
Shakir
S A
SA
D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000188:drug therapy; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D000077265:Donepezil; D011307:Drug Prescriptions; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007189:Indans / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009325:Nausea / Q000139:chemically induced; D018697:Nootropic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D011358:Product Surveillance, Postmarketing; D014839:Vomiting / Q000139:chemically induced
D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil