Introduction
Since there is no cure for Alzheimer’s disease, it is one of the significant issues of the modern day. Alzheimer’s patients experience memory loss and trouble finding the appropriate phrases in the early stages of the illness. The sick people’s emotional statements are likewise erratic. The development of emotional lability causes sick persons to experience sadness or rage. As the ill persons lost their sense of self and communication grew more challenging, they became more reserved. This research is focused on investigating memantine and donepezil, the most potent medications for treating Alzheimer’s.
Benefits and Risks for Implementation
The combination of memantine and donepezil treats dementia, memory loss, and mental changes brought on by mild to moderate Alzheimer’s disease. While memantine and donepezil would not treat Alzheimer’s disease, they might enhance cognitive, behavioral, or practical abilities. Comparing all available remedies, donepezil is thought to have the highest efficacy. Its approval for use across all stages of Alzheimer’s disease explains why. Alternative medications, however, can be used in either the first or second stages of Alzheimer’s disease. For example, memantine is approved for treating moderate to severe stages of Alzheimer’s disease, but galantamine, rivastigmine, and tacrine are approved for mild to intermediate stages of the condition.
Risks
Similar to other cholinesterase inhibitors, donepezil has side effects that put patients’ health at risk. Slow heart rate, chest pain, fainting, respiratory issues, seizures, lower back pain, fever, and bloody vomiting are some serious adverse effects of donepezil. Other typical adverse effects include
- a lack of appetite;
- muscle spasms;
- weight loss;
- severe weariness;
- headache;
- dizziness;
- sleeplessness.
It is also known to cause urinary tract issues, darkening of the skin, and passing bloody stool. Additionally, it results in hallucinations, anxiety, agitation, diarrhea, joint pain, and vomiting. According to Adlimoghaddam et al., cholinergic drugs like donepezil typically have gastrointestinal side effects (2018). Although the mechanism has not been determined, donepezil has been observed to produce weight reduction in certain patients. In contrast, donepezil and all other cholinesterase inhibitors result in nausea, vomiting, lack of appetite, and alterations in bowel habits. Digestion issues, headaches, disorientation, and loss of balance are side effects of the non-cholinesterase inhibitor memantine.
Suggestions
There are a few known contraindications of donepezil. For example, donepezil is not advised for use in pregnant patients or those who have previously experienced an adverse reaction to piperidine derivatives. On the other hand, people with certain medical disorders, including Parkinson’s, heart disease, asthma, obstructive lung disease, and ulcers, are not advised to take this medication. The formulations of donepezil are an additional factor that should make it the medicine of choice over all others. First and foremost, it is offered in tablet and tablet dissolving form factors, both of which are convenient. Compared to other medications, which must be taken twice to three times daily, these forms provide enough quantities of 23 mg daily. As a result, it offers patients a straightforward and practical dosage.
Dosages
Two dosage variants of donepezil are offered in terms of formulation. It is available in tablet or tablet-decaying form. The medicine is conveniently formulated in both formulations to contain 23 mg, allowing one whole pill to swallow per dosage.
On the other hand, rivastigmine comes in capsule and solution form, with dosages of 1.5, 3, 4.5, and 6 mg for the former and 2 mg/ml for the latter. Similar to tablet-formulated galantamine, this medication should be taken twice daily. According to Birks & Harvey, the benefits from taking 23 mg/day were comparable to those from taking 10 mg/day, and those from taking 10 mg/day were somewhat superior to those from taking 5 mg/day (2018). However, the higher the dose, the higher the rates of withdrawal and adverse events before the conclusion of therapy. Concerning problems with formulation, donepezil is known to be stable and is kept at room temperature. Since all complementary medicines are likewise kept at room temperature, there are no storage-related formulation issues.
Costs
According to Marešová et al., the meta-analysis produced an estimated total cost per patient per year of $20,461 total costs. According to the MMSE scale, the total costs are $14,675 for a light stage of the condition, $19,975 for a moderate set, and $29,708 for a severe stage. The meta-analysis reveals that costs increase dramatically as AD becomes more powerful.
From a critical aspect, donepezil should be used to treat Alzheimer’s disease instead of any other complementary medicines. This is true since memantine, a mixture with a distinct mechanism of action from cholinesterase inhibitors has been discovered to have a low efficacy compared to the drug. The only medication recognized for treating Alzheimer’s disease at all stages is donepezil. Additionally, it has a straightforward pharmacokinetics mechanism of action that has no detrimental effects on the nervous system. Donepezil has not been found to have the adverse health effects associated with tacrine compared to the other cholinesterase inhibitors.
Final Considerations
In conclusion, while it does not treat dementia, the drug donepezil effectively treats some forms of the disease. However, it helps with mixed dementia and some symptoms of Alzheimer’s disease, Parkinson’s disease, or dementia with Lewy bodies. When treating the main symptoms of this condition, donepezil is more beneficial than a placebo and is well tolerated. Donepezil reduces the onset of Alzheimer’s disease and temporarily reverses the transition from mild cognitive impairment to the illness.
References
Adlimoghaddam, A., Neuendorff, M., Roy, B., & Albensi, B. C. (2018). “A review of clinical treatment considerations of donepezil in severe Alzheimer’s disease.” CNS neuroscience & therapeutics, 24(10), 876-888. Web.
Birks, J. S., & Harvey, R. J. (2018). “Donepezil for dementia due to Alzheimer’s disease.” Cochrane Database of systematic reviews, 3(6). Web.