P-501 - Use of donepezil for the treatment of depression in the absence of cognitive impairment

Abstract

Background: Donepezil is a reversible, centrally-acting acetylcholinesterase inhibitor used in the treatment of mild to moderate symptoms of dementia associated with Alzheimer's disease. In recent years, there has been emerging evidence of its use in other conditions, such as Lewy Body dementia and autism. However, there have been few reports of the use of Donepezil to treat depression in the absence of cognitive impairment. Methods: This is a case report of a 62-year old female with a long-standing history of major depressive disorder with no history of cognitive impairment, who failed to respond to antidepressants with augmentation therapy including antipsychotics , lithium and methylphenidate; but eventually improved on Donepezil. Results: A then-56-year old Chinese lady diagnosed with major depressive disorder, was treated with several antidepressants with poor response. Despite augmentation with dual antidepressants, antipsychotics, methylphenidate and lithium, her symptoms of avolition, depressed mood and irritability persisted. After 4 years of antidepressant treatment, she was started on donepezil 5mg. Within a month of augmentation, significant improvement in symptoms were reported, notably in mood and volition, and the patient was able to engage in an active and meaningful lifestyle of semblance to her pre-morbid mental state. Conclusion: This case highlights the possibility of Donepezil being used as an adjunctive therapy in major depressive disorder, even in the absence of cognitive impairment. Future studies to investigate the use of Donepezil may therefore be worthwhile to explore its use in this population of patients.

Donepezil Beyond Alzheimer's Disease? A Narrative Review of Therapeutic Potentials of Donepezil in Different Diseases

“…The results indicated the efficacy of donepezil in improving the symptoms of anxiety, depression, and cognition impairment (81). Moreover, in a case report by Lim et al, the antidepressant effect of donepezil at a dose of 5 mg as adjunctive therapy was noticed in a 62-year-old woman with a history of depression without any cognitive problems whose depression was resistant to routine depression treatments and even nextline drugs (82). However, as previously stated, some studies have shown inconsistent evidence regarding donepezil's efficacy in treating depression (80,83).…”