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Side Effects of Donepezil (Aricept)


Description: Donepezil (Aricept) is a medication used to treat dementia. Aricept is FDA-approved to treat Alzheimer’s dementia but has been used “off label” to treat dementia associated with Parkinson’s disease and Lewy body dementia.


Aricept is an acetylcholinesterase inhibitor, which means it blocks the acetylcholinesterase enzyme in the brain. This increases acetylcholine neurotransmission in the brain; decreased acetylcholine neurotransmission is one of the effects of Alzheimer’s dementia.


Serious Aricept Side Effects


Some Aricept adverse effects are rare but dangerous. The most serious among them is cardiac related issues. Donepezil may be associated with QT prolongation and Torsade de pointes, both of which can cause deadly changes in heart rhythm. Another of the known donepezil side effects is bradycardia, or abnormally slow heart rate. People with cardiac arrhythmias, sick sinus syndrome, or other forms of pathologic bradycardia may not be candidates for Aricept.


One of the most serious donepezil side effects is rhabdomyolysis. Rhabdomyolysis is a condition that causes muscle cells to break down, spilling their contents into the bloodstream. These contents then move to the kidneys, causing further damage (e.g. renal failure). Fortunately, rhabdomyolysis is one of the rare donepezil adverse effects.


Lastly, even though donepezil (Aricept) is not a neuroleptic, one of the known Aricept adverse effects is neuroleptic malignant syndrome. Neuroleptic malignant syndrome is a potentially life-threatening neurological condition that causes very high fever, altered mental state, muscular spasms and rigidity, and an erratic blood pressure. As with rhabdomyolysis, neuroleptic malignant syndrome is one of the very rare donepezil side effects.


The Most Common Aricept Side Effects


The most common Aricept side effects are insomnia, loss of appetite, nausea, diarrhea, muscle cramps, infection, and accidental injury. It is important to remember that these effects were assessed in people with active Alzheimer’s disease compared to placebo.


It is unclear how many of Aricept side effects are caused by the treatment of the drug or the underlying illness. One example is accidental injury. While 10% of Alzheimer’s disease patients experience accidental injury while taking donepezil, it is unclear how many people with Alzheimer’s disease experience accidental injury simply taking placebo or on no dementia treatment at all.


Less Common Side Effects of Aricept


Less common side effects include:

  • Abnormal dreams
  • Constipation
  • Dizziness and fainting
  • Drowsiness
  • Easy bruising or bleeding
  • Frequent urination
  • Headache
  • Joint pain or stiffness
  • Weight loss (perhaps due to decreased appetite)
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