Donepezil and α-synuclein Constipation: A 48 Month Follow-Up

Abstract

In a case study, four patients diagnosed at different stages of disease progression with the α‐synuclein or Lewy body disorders Parkinson’s disease (PD) and Neurocognitive Disorder with Lewy Bodies (NCDLB) were treated with the acetylcholinesterase inhibitor (AChEI) Donepezil to address the symptoms of constipation, obstipation and impaction. The use of Donepezil was associated with significant symptom reduction for each of the four patients. In follow-up studies conducted at intervals of six, twelve, eighteen, thirty-six and forty-eight months, symptom improvement was maintained with no apparent reduction in bowel motility, nor the emergence of any new symptoms. The results suggest that the AChEI Donepezil can have long-term benefit in reducing the symptoms of constipation, obstipation and impaction in patients with α-synuclein disorders. Keywords: Neurocognitive Disorder with Lewy Bodies, Parkinson’s disease, constipation, Donepezil, acetylcholinesterase inhibitor