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CARDIOVASCULAR SAFETY PROFILE OF DONEPEZIL IN MODERATE TO SEVERE DEMENTIA OF THE ALZHEIMER TYPE.
De Ridder M1, De Roeck M2, Van Dongen J1, Vandewoude M1, University Department Geriatrics1, Dept Cardiology2, ZNA (Ziekenhuisnetwerk Antwerpen)/University of Antwerp, Belgium.
AIM
Because donepezil has a cholinergic action, we studied its effect on electric conductance through ECG parameters in hospitalised patients with moderate to severe dementia of the Alzheimer type.
METHOD
Donepezil na?ve Alzheimer patients fulfilling the criteria for initiating therapy were included during a 12-month period. Exclusion criteria were a pacemaker or any active cardiovascular condition. Concomitant medication was registered and allowed when no change occurred during the observation period. ECG?s (3x3) were taken before therapy, after 1 week of donepezil 5 mg/d and after upgrading to 10 mg/d. Blood Pressure and heart rate were recorded in the morning. In every patient mean values for every donepezil level were calculated for heart rate, P-wave, QRS-complex, intervals of PQ, QT, QTc, RR, PP and Axis of P/QRS/T-waves. One-way ANOVA was used to test differences between means.
RESULTS
Patients (n=43; MMSE=18.0?5.3) had a mean age of 83.3?5.2 years. The table shows BP, heart rate, PQ and QTc changes with increasing donepezil dose. Neither did the other measured ECG-variables show any statistically significant change.
Pre Donepezil Donepezil 5 mg Donepezil 10 mg P
Syst BP (mmHg) 135,2?4,2 132,0?4,4 129,6?2,9 0.667
Diast BP(mmHg) 67,5?2,3 66,1?2,2 65,8?2,4 0.857
HR (/min) 75,2?3,1 72,3?3,0 70,3?3,1 0.526
PQ (ms) 162?9 173?8 71?12 0.657
QTcB (ms) 423,7?6,6 418,3?8,0 431,9?4,3 0.453
CONCLUSION
Donepezil does not significantly change heart rate, blood pressure and classic ECG indices in hospitalised patients with moderate Alzheimer disease. It proves to be a safe therapy in this population.
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