Confusion donepezil

Further evidence that donepezil is effective and well tolerated in treating symptoms of mild to moderately severe Alzheimer s disease has emerged from a multinational trial (26). Common adverse effects were nausea, vomiting, diarrhea, anorexia, dizziness, and confusion, consistent with previous findings. 

Two elderly patients with Alzheimer s disease and a mood disorder were treated with donepezil 5 mg/day and paroxetine 20 mg/day. One of them became agitated, confused, and aggressive, and donepezil was withdrawn after 8 days. On reintroduction of donepezil she again became rapidly confused, irritable, and verbally aggressive. In the other case, while the patient was taking paroxetine, donepezil 5 mg/day resulted in severe diarrhea, flatulence, and insomnia. The dosage of donepezil was reduced to 5 mg on alternate days, but the diarrhea and flatulence persisted. The symptoms resolved when donepezil was stopped. 

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