Cholinesterase inhibitors in advanced dementia with Lewy bodies: increase or stop?

Pakrasi, Sanjeet; Thomas, Alan; Mosimann, Urs P.; Cousins, David A.; Lett, Debbie; Burn, David J.; O'Brien, John T.; McKeith, Ian G. (2006). Cholinesterase inhibitors in advanced dementia with Lewy bodies: increase or stop? International journal of geriatric psychiatry, 21(8), pp. 719-721. Wiley-Blackwell 10.1002/gps.1547

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INTRODUCTION There is little data on stopping cholinesterase inhibitors in Dementia with Lewy bodies (DLB). Equally, it is not known if increasing the dose of cholinesterase inhibitors may help neuropsychiatric symptoms in advanced DLB. METHOD We conducted an open label trial with donepezil involving 16 patients with LBD when the dose was reduced and treatment stopped over 4 weeks. Another 7 patients were given a trial of an increased dose of donepezil (15 mg) to resolve rehyphen;emergent neuropsychiatric symptoms. RESULTS The slow discontinuation protocol was well tolerated in advanced DLB. Five of the seven patients given a trial of a higher dose of donepezil were rated as clinically improved after 12 weeks treatment. CONCLUSION Cholinesterase inhibitors can be discontinued slowly in advanced DLB. Increasing the dose of donepezil may be of benefit to some patients with DLB who experience a recurrence in their neuropsychiatric symptoms.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Geriatric Psychiatry and Psychotherapy

UniBE Contributor:

Mosimann, Urs Peter


600 Technology > 610 Medicine & health








Pascal Wurtz

Date Deposited:

11 Jul 2014 10:52

Last Modified:

11 Jul 2014 10:52

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

dementia, Lewy bodies, cholinesterase inhibitors, treatment, discontinuation, dose escalation


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