Abstract
Dementia can be seen as a clinical syndrome featuring a decline in cognitive and psychological abilities that can cause disability. Two major kinds of drugs are available: N-methyl-D-aspartic acid receptor antagonists like memantine and acetylcholinesterase inhibitors such as galantamine, rivastigmine and donepezil. In this article, we have reviewed the available literature along with the provision of a snapshot of published cases in the literature We used the PubMed database for our search. The average age of patients was 80 years and above. Patients described in the literature belonged to both female and male gender, with female patients being predominant. Patients demonstrated associated atrioventricular (AV) block or ventricular premature contractions (VPC) or atrial fibrillation (AF) prior to developing torsades de pointes (TdP). Presenting complaints were either syncope or diarrhoea or accidental bradycardia. Mostly, the corrected QT interval (QTc) normalisation was associated with discontinuation of donepezil. We recommend further studies to determine this correlation between donepezil and incidence of QTc prolongation and TdP.
Highlights
BackgroundDementia can be seen as a clinical syndrome featuring a decline in cognitive and psychological abilities that can cause disability [1]
We recommend further studies to determine this correlation between donepezil and incidence of QTc prolongation and torsades de pointes (TdP)
In some of the case reports described in the literature, an association has been found between donepezil and ventricular arrhythmias, especially TdP, QTc prolongation, bradycardia, and heart blocks [17]
Summary
Dementia can be seen as a clinical syndrome featuring a decline in cognitive and psychological abilities that can cause disability [1]. An 87-year-old female was admitted to the hospital because of syncope and subsequent fall sustaining a vertebral fracture Her past medical history was AD, bradycardia, AF, and hypertension. In some of the case reports described in the literature, an association has been found between donepezil and ventricular arrhythmias, especially TdP, QTc prolongation, bradycardia, and heart blocks [17]. Other precipitating factors identified to be associated with the above-mentioned cardiac conduction disorders from these case reports are hypokalaemia, acute colitis, diarrhoea, apical cardiac aneurysm, triple vessel disease, previous MI, and interactions with drugs like fluoxetine and benidipine (beware of drugs that prolong QTc) [17]
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