[Doubtful evidence for the use of the cholinesterase inhibitor donepezil in patients with dementia--a systematic review]

Fortschr Neurol Psychiatr. 2004 Oct;72(10):557-63. doi: 10.1055/s-2004-830077.
[Article in German]

Abstract

Objective: Objective of this systematic review is to determine the level of scientific evidence for the use of Donepezil in Alzheimer's Disease.

Methods: Ten randomised controlled double-blind trials testing Donepezil versus Placebo were identified in MEDLINE and EMBASE. All ten trials were included in this systematic review. Following a detailed catalogue of criteria the methodological standard of the ten trials was assessed.

Results: The authors of eight trials postulated statistically significant differences in favour of Donepezil. Unfortunately, the methodological standard of all studies was insufficient. The methodological shortcomings are discussed in detail.

Conclusion: With regard to severe methodological deficiencies the evidence for the use of Donepezil in moderate to severe Alzheimer's Disease is lacking. But even if the trials had been conducted in a methodologically correct way the clinical relevance of the postulated positive results would have to be questioned.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / psychology
  • Cholinesterase Inhibitors / therapeutic use*
  • Donepezil
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Indans / therapeutic use*
  • Male
  • Nootropic Agents / therapeutic use*
  • Piperidines / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Research Design

Substances

  • Cholinesterase Inhibitors
  • Indans
  • Nootropic Agents
  • Piperidines
  • Donepezil