Tratamiento con donepecilo en pacientes con deterioro cognitivo vascular y postraumático: observaciones clínicas

The Effectiveness of Donepezil for Cognitive Rehabilitation After Traumatic Brain Injury

“…The efficacy and safety of donepezil in treating cognitive dysfunction after TBI does not seem to be different from other AChEIs such as galantamine and rivastigmine. 11 Regarding safety, whereas noncomparative trials present evidence for the appearance of nonnegligible cholinergic and behavioral adverse effects, which seem to be dose dependent on donepezil, 14,16,17,19,21 comparative trials do not report such problems. A single case of severe adverse effect has been reported so far in an RCT.…”

“…22 Moreover, the improvement reported in cognitive outcomes cannot be uniquely attached to the donepezil treatment. Other factors, such as natural or spontaneous recovery, or the concomitant treatment with other drugs with action on the central nervous system 13,14,17,22 could equally be responsible for the reported improvement.…”

“…10 We also found 1 pseudo-RCT, which compared the efficacy and safety of 3 AChEIs (donepezil, galantamine, and rivastigmine) 11 and 1 matched cohort study. 12 The remaining 10 studies were noncomparative trials, which included case reports, [13][14][15][16] single-subject designs, 17,18 and case series. [19][20][21][22] Apart from a Spanish 14 and another Chinese article, 9 all studies used English as the publication language.…”

“…14,16,17,19,21 The main reasons stated for discontinuation were agitation, 14,16 aggression, 16 muscle cramps, 14 lethargy and somnolence, 17 insomnia, 21 diarrhoea, 21 and nausea. 19…”