Urinary incontinence donepezil

Urinary incontinence may often be disregarded as a manifestation of dementia, but it has also been attributed to donepezil. 

Urinary incontinence in patients with Down syndrome treated with donepezil has been described before (67). Urinary incontinence can be a major concern and a source of distress, not only for patients but also for caregivers. Clinicians should be alert to the possibility of urinary incontinence when prescribing donepezil for individuals with Alzheimer s disease. The authors emphasized that the incontinence may often be transient and not serious, but it could limit a patient s activities and quality of life and could also affect therapeutic adherence. 

Three patients with Alzheimer s disease associated with Down syndrome were treated with donepezil (67). One became agitated and aggressive the other two developed urinary incontinence. In all three cases donepezil was withdrawn. These results are important, because many individuals with Down syndrome... 

Hashimoto M, Imamura T, Tanimukai S, Kazui H, Mori E. Urinary incontinence an unrecognised adverse effect with donepezil. Lancet 2000 356(9229) 568. 

Adverse effects inevitably include cholinergic symptoms with nausea, diarrhoea and abdominal cramps appearing commonly. There may also be bradycardia, sinoatrial or atrioventricular block. Urinary incontinence, syncope, convulsions, and psychiatric disturbances also occur. Rapid dose increase appears to make symptoms more pronounced. Hepatotoxicity is a rare association with donepezil. 

---