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The Beneficial Effect of Donepezil on Visual Hallucinations in Three Patients with Parkinson's Disease

Department of Neurology, Jikei University School of Medicine, Tokyo, Japan, a-kurita{at}jikei.ac.jp.

Yusuke Ochiai, MD

Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan

Yu Kono, MD

Department of Neurology, Jikei University School of Medicine, Tokyo, Japan

Masahiko Suzuki, MD, PhD

Department of Neurology, Jikei University School of Medicine, Tokyo, Japan

Kiyoharu Inoue, MD, PhD

Department of Neurology, Jikei University School of Medicine, Tokyo, Japan

Visual hallucinations (VHs) are common psychiatric symptoms in patients with long-standing Parkinson's disease (PD). Treatment with neuroleptics or withdrawal of anti-PD drugs may improve VHs but will worsen motor dysfunctions. The authors report on 3 patients with long-standing PD who were treated with the cholinesterase inhibitor donepezil for the treatment of VHs. Each received a daily dose of 5 mg of donepezil, after reducing or discontinuing anti-PD medications had failed to relieve the VHs. In 2 patients (patient 1, 2), donepezil decreased VHs without worsening motor dysfunctions. In addition, the cognitive status of patient 2 improved. In patient 3, donepezil also resolved VHs, but delusions developed during treatment. After discontinuing donepezil, delusions disappeared and VHs reappeared. Donepezil may ameliorate visual hallucinations in PD patients, but controlled, double-blind trials are necessary to further clarify the effect of this drug on VHs in PD. (J Geriatr Psychiatry Neurol 2003; 16:184-188).

Key Words: Parkinson's disease • acetylcholinesterese inhibitor • donepezil • visual hallucinations • cognitive impairment • motor functions

Journal of Geriatric Psychiatry and Neurology, Vol. 16, No. 3, 184-188 (2003)
DOI: 10.1177/0891988703256054


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