An open trial of adjunctive donepezil in attention-deficit/hyperactivity disorder.
OBJECTIVE
Despite available pharmacotherapeutics, a number of youths with attentiondeficit/ hyperactivity disorder (ADHD) continue to experience residual symptoms and prominent executive function (EF) deficits resulting in impairment in multiple domains. We sought to determine if donepezil, used adjunctively to stimulant medication, would improve residual symptoms of ADHD and EF deficits.


METHODS
In a 12-week open trial, we treated 7 children and 6 adults who had ADHD and evidence of further EF deficits with adjunctive donepezil. All subjects were stabilized on stimulants, at which time donepezil was initiated at 2.5 mg daily and increased to a maximum of 10 mg over the 12-week trial.


RESULTS
Of 13 subjects receiving medication, 7 completed the trial. There was no clinically or statistically significant improvement in the ADHD Rating Scale and the Executive Function Checklist, our primary outcome measures. A majority of individuals experienced nonserious adverse events.


CONCLUSIONS
Results of this small open study suggest that donepezil augmentation of stimulants is not well tolerated and does not appear useful for the treatment of residual ADHD and/or EF deficits.
Wilens
Timothy E
TE
Pediatric Psychopharmacology Unit, YAW 6A, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. twilens@partners.org
Waxmonsky
James
J
Scott
Megan
M
Swezey
Allison
A
Kwon
Anne
A
Spencer
Thomas J
TJ
Biederman
Joseph
J
D000293:Adolescent; D000328:Adult; D000662:Amphetamines / Q000009:adverse effects / Q000627:therapeutic use; D018692:Antimanic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy; D000077265:Donepezil; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007189:Indans / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D011594:Psychometrics / Q000706:statistics & numerical data; D016896:Treatment Outcome
D000662:Amphetamines; D018692:Antimanic Agents; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D008774:Methylphenidate; D000077265:Donepezil