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    Donepezil (Aricept®), ein selektiver reversibler Hemmstoff der Acetylcholinesterase, ist zugelassen zur symptomatischen Behandlung der leichten bis mittelschweren Alzheimer-Demenz. Die Tendenz der Verordnung ist stark steigend, ebenso wie bei den anderen Cholinesterasehemmern Galantamin (Reminyl®) und Rivastigmin (Exelon®). Wie in den Therapieempfehlungen der AkdÄ zur Demenz ausgeführt wurde, konnte nach sechsmonatiger Behandlungsdauer ein geringer, aber statistisch signifikanter positiver Effekt von Donepezil auf die kognitive Leistung, das globale Arzturteil und die Alltagskompetenz belegt werden; eine günstige Beeinflussung von Endpunkten wie Pflegebedürftigkeit und Progression der Alltagsbeeinträchtigung bleibt jedoch umstritten (1). Die häufigsten unerwünschten Arzneimittelwirkungen von Donepezil sind Übelkeit (16 %), Erbrechen (10 %), Diarrhö (13 %), Müdigkeit (8 %), Schlafstörungen (8 %) und Muskelkrämpfe (8 %) (2; 3). Es wird jetzt über einen 82-jährigen Patienten berichtet, der wegen Schwindel und Synkope stationär aufgenommen wurde (4). Er hatte zuvor für einen Monat Donepezil 10 mg/Tag zur Behandlung eines M. Andere Arzneimittel wurden nicht eingenommen, und eine kardiale Vorerkrankung bestand nicht. Bei der Krankenhausaufnahme lagen der Blutdruck bei 100/60 mm Hg und die Herzfrequenz bei 35/Minute. Das EKG zeigte einen kompletten AV-Block und nicht anhaltende ventrikuläre Tachykardien. Der Patient wurde mit einem temporären Schrittmacher versorgt und intensivmedizinisch überwacht. Treating Dementia with Aricept Donepezil - Kindly Care Donepezil ALZFORUM Donepezil ARICEPT, ARICEPT 23 - Worst Pills
     
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