The beneficial effect of donepezil on visual hallucinations in three patients with Parkinson's disease.
Visual hallucinations (VHs) are common psychiatric symptoms in patients with long-standing Parkinson's disease (PD). Treatment with neuroleptics or withdrawal of anti-PD drugs may improve VHs but will worsen motor dysfunctions. The authors report on 3 patients with long-standing PD who were treated with the cholinesterase inhibitor donepezil for the treatment of VHs. Each received a daily dose of 5 mg of donepezil, after reducing or discontinuing anti-PD medications had failed to relieve the VHs. In 2 patients (patient 1, 2), donepezil decreased VHs without worsening motor dysfunctions. In addition, the cognitive status of patient 2 improved. In patient 3, donepezil also resolved VHs, but delusions developed during treatment. After discontinuing donepezil, delusions disappeared and VHs reappeared. Donepezil may ameliorate visual hallucinations in PD patients, but controlled, double-blind trials are necessary to further clarify the effect of this drug on VHs in PD.
Kurita
Akira
A
Department of Neurology, Jikei University School of Medicine, Tokyo, Japan. a-kurita@jikei.ac.jp
Ochiai
Yusuke
Y
Kono
Yu
Y
Suzuki
Masahiko
M
Inoue
Kiyoharu
K
D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis; D000077265:Donepezil; D005260:Female; D006212:Hallucinations / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D010880:Piperidines / Q000627:therapeutic use*; D011596:Psychomotor Disorders / Q000175:diagnosis; D012720:Severity of Illness Index
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil