A randomized, double-blind, placebo-controlled trial of donepezil to improve memory in epilepsy.
OBJECTIVE
To determine whether an acetylcholinesterase inhibitor, such as donepezil, would improve memory or other cognitive/psychological functions in epilepsy patients with subjective memory complaints.


METHODS
Twenty-three epilepsy patients with subjective memory difficulty were randomized to either 3 months of donepezil (10 mg/day) or 3 months of placebo treatment, and then crossed over to the other treatment arm. Patients and physicians were blinded to treatment phase throughout data acquisition. Assessment of memory and other cognitive functions, subjective memory, mood, and self-rated quality of life (QOL) and social functioning was performed at baseline and following completion of both treatment phases. Seizure frequency and severity as well as treatment emergent adverse effects were also monitored.


RESULTS
Donepezil treatment was not associated with improvement in memory or other cognitive functions, mood, social functioning or QOL. Comparable increases in self-rated memory functioning relative to baseline were evident during donepezil and placebo phases. Donepezil treatment was not associated with increased seizure frequency or severity. Similar to group results, analysis of change within individual patients as a function of treatment phase also showed neither significant benefit nor detriment associated with donepezil.


CONCLUSIONS
This study found no benefit on memory or other cognitive/psychological functions in a heterogeneous group of epilepsy patients with subjective memory difficulty. Further investigation would be required to determine whether individual patients, or those with particular epilepsy syndromes, might benefit from donepezil or other acetylcholinesterase inhibitors, or if a higher dosage might be effective.
Hamberger
Marla J
MJ
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA. mh61@columbia.edu
Palmese
Christina A
CA
Scarmeas
Nikolaos
N
Weintraub
David
D
Choi
Hyunmi
H
Hirsch
Lawrence J
LJ
D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy; D018592:Cross-Over Studies; D000077265:Donepezil; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D006304:Health Status; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008569:Memory Disorders / Q000188:drug therapy* / Q000523:psychology; D009483:Neuropsychological Tests; D010880:Piperidines / Q000627:therapeutic use*; D010919:Placebos; D011788:Quality of Life; D012720:Severity of Illness Index; D012917:Social Adjustment; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D010919:Placebos; D000077265:Donepezil