[Donepezil therapy in patients with vascular and post-traumatic cognitive impairment: some clinical observations]

Abstract

Introduction: Donepezil is a procholinergic drug that slows down cognitive and functional impairment in patients with Alzheimer's disease. Little research has been carried out to study its effect in other types of neurobehavioural disorders.

Aims: The purpose of this study was to describe the response to donepezil therapy in patients with neurobehavioural disorders due to vascular and post-traumatic causes.

Case reports: Donepezil was administered to four patients with mild cognitive impairment due to vascular causes, to two patients with vascular dementia and to two patients with post-traumatic dementia. Following an average time of four months, the effects exerted on the cognitive, functional and behavioural areas were evaluated. One patient did not tolerate the drug and another suffered an episode of congestive heart failure that gave rise to a moderate neurobehavioural exacerbation. Two patients underwent a moderate improvement, three patients showed a slight improvement and no changes were observed in one patient. In general, memory, attention, depression, apathy and psychotic traits tended to improve. Aggressiveness/irritability tended to get worse. The functional repercussions of these changes were negligible or inexistent.

Conclusions: Treatment with donepezil improved cognition and conduct in patients with neurobehavioural disorders due to vascular or post-traumatic causes. These results will have to be confirmed and expanded by means of controlled studies, and research must continue into the characteristics of responding patients and the relevance of their responses.