New Drugs IV – Donepezil (Aricept®), Levofloxacin (Levaquin®), Pantoprazole (Pantoloc®), Quetiapine (Seroquel®) | Therapeutics InitiativeInhibits acetylcholinesterase, increasing the amount of acetylcholine in synapses and potentially enhancing brain cholinergic neurotransmission.Three randomised controlled trials (RCTs) compared donepezil with placebo in patients with mild to moderate Alzheimer's Disease. The first trial (N=161) compared donepezil (1, 3 or 5 mg/d) with placebo in a 12-week double blind trial. Small statistically significant improvements in cognitive scores (3.2 out of 70) occurred in the 5 mg donepezil group. Caregivers (e.g. spouse) could not discern any difference.(1) A second similar 24-week trial (2) compared placebo (N=162) with donepezil 5mg/d (N=154) or 10 mg/d (N=157). Endpoint cognitive scores improved by 2.8 points in the group receiving 10 mg/d (p 0.0001). The third 15-week trial (N=468) compared placebo with donepezil 5 mg/d or 10 mg/d.(3) Again the 2 donepezil groups did statistically significantly better on 3 different scores, including a clinicians global assessment of change.
