Science Links Japan | Acute aggravation of parkinsonism by donepezil overdose. A case report. TOP J-EAST List of Journal Titles (N) Neurological Medicine(2006) Acute aggravation of parkinsonism by donepezil overdose. A case report. NAKAO HIRO(Shinwakai Kyoutomin'iren Dainichuuoubyouin) NAKAO HIRO(Dojinkai Mimihara General Hospital, JPN) MUNAKATA RIE(Shinwakai Kyoutomin'iren Dainichuuoubyouin) TAKAGI YUKIO(Shinwakai Kyoutomin'iren Dainichuuoubyouin) ISONO OSAMU(Kyoutohokenkai Kyoutomin'iren Chuuoubyouin) MON YUSUKE(Shinwakai Kyoutomin'iren Dainichuuoubyouin) A 79-year-old woman with senile dementia of Alzheimer type took 36 tablets of 5mg donepezil chloride for the purpose of suicide. She was found by her daughter next morning and was transferred to our hospital. On physical examination, she could not stand up with rigidity and resting tremor, that is, obvious parkinsonism. And the laboratory test revealed a high serum concentration of donepezil chloride. With only intravenous hydration, the concentration of donepezil decreased and her activity also improved up to the level before the accident. This clinical course indicates this acutely worsened parkinsonism was due to donepezil overdose. Our case showed obvious central nervous system symptoms compared with other cholinergic crisis symptoms that were documented by previous four case reports. Because donepezil chloride is considered to have high selectivity to the central nervous system as cholinesterase inhibitor, we suppose that the central nervous system symptoms are also an important side effect of donepezil chloride. (author abst.
