Added donepezil for stable schizophrenia: a double-blind, placebo-controlled trial.
BACKGROUND
Schizophrenia is a disorder with cognitive deficits that could stem from cholinergic dysfunction.


OBJECTIVE
Our aim was to examine if donepezil administered to stable, medicated outpatients with schizophrenia improves cognition and psychopathology.


METHODS
We conducted a double-blind placebo-controlled trial of donepezil up to 10 mg/day added for 8 weeks to ongoing antipsychotic treatment in 36 typical community-treated schizophrenia patients not selected for cognitive impairment.


RESULTS
Donepezil did not improve measures of cognition or psychopathology. It was well tolerated.


CONCLUSIONS
Consistent with other studies, addition of donepezil to stable patients with schizophrenia did not improve cognition or measures of psychopathology. This result does not support the hypothesis that residual symptoms and cognitive problems result from a cholinergic deficit that can be remedied by an acetylcholinesterase inhibitor. A donepezil add-on strategy might make sense in selected schizophrenia cases where a pathological process is known to affect cholinergic neurons (e.g., history of head injury or comorbid dementia).
Freudenreich
Oliver
O
MGH Schizophrenia Program, Freedom Trail Clinic, Boston, MA 02114, USA.
Herz
Lawrence
L
Deckersbach
Thilo
T
Evins
A Eden
AE
Henderson
David C
DC
Cather
Corinne
C
Goff
Donald C
DC
D002214:Capsules; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy; D000077265:Donepezil; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D020820:Dyskinesias / Q000209:etiology; D005260:Female; D006801:Humans; D007189:Indans / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010919:Placebos; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012798:Sialorrhea / Q000139:chemically induced; D013997:Time Factors; D016896:Treatment Outcome
D002214:Capsules; D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D010919:Placebos; D000077265:Donepezil