Abstract
Donepezil has been approved for treatment of Alzheimer's disease. The common adverse reactions of donepezil in the treatment of Alzheimer's disease include diarrhea and nausea. However, there are also some other rare clinical cases been reported on administration of donepezil, such as mania and delirious behavior. Here, we report a patient with Alzheimer’s disease who was induced the onset of rheumatoid arthritis upon treatment with donepezil.
Highlights
Donepezil, rivastigmine and galantamine, three acetylcholinesterase/ cholinesterase (AChE/ChE) inhibitors on the market are considered the standard treatment of the mild-moderate stage of Alzheimer’s disease (AD) [1,2,3]
We reviewed literature and found that studies assessing the effect of AChE inhibition upon inflammation have yielded conflicting results
In a lipopolysaccharides (LPS)-stimulated human macrophage cultures experiment, Borovikova et al found that ACh significantly attenuated the release of TNF, IL-1β, IL-6 and IL-18, but not the anti-inflammatory cytokine IL-10, and they further demonstrated that during lethal endotoxemia in rats, direct electrical stimulation of the peripheral vagus nerve inhibited TNF synthesis in liver, attenuated peak serum TNF amounts, and prevented the development of shock [8]
Summary
Rivastigmine and galantamine, three acetylcholinesterase/ cholinesterase (AChE/ChE) inhibitors on the market are considered the standard treatment of the mild-moderate stage of Alzheimer’s disease (AD) [1,2,3]. The most frequently reported adverse events associated with donepezil were diarrhea 12%, nausea 11%, vomiting 7%, dizziness 8%, and weight loss 7% [3]. As these adverse events are usually mild and transient, there are some other clinical cases been reported on administration of donepezil, such as mania and delirious behavior [5,6]. Withdrawal of donepezil effectively attenuated the symptoms of RA. The patient and her family provided informed consent for publication
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