Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Clin Psychopharmacol. 2013 Jun;33(3):351-5. doi: 10.1097/JCP.0b013e31828b5087.
Donepezil has been approved, and higher dosages are recommended for the treatment of Alzheimer disease (AD). However, a few studies have reported different cognitive responses in patients with AD treated with donepezil without measuring the concentration.
We evaluated the relationships between the therapeutic responses and plasma concentrations of donepezil in various cognitive domains using the Cognitive Ability Screening Instrument among 37 patients with newly diagnosed mild stage AD taking donepezil 5 mg/d.
Among the 9 cognitive domains in the Cognitive Ability Screening Instrument, the long-term memory domain had the highest improvement ratio (81.1%) compared with the other domains. An increased donepezil plasma concentration [mean (SD), 75.14 (32.16) ng/mL] was significantly associated with the improvement of long-term memory (P = 0.045; odds ratio, 0.959; 95% confidence interval, 0.920-0.999) after adjusting for age, sex, education, and apolipoprotein E genotype.
Although there are some limitations in our study, these findings indicate that a higher concentration of donepezil improves long-term memory in patients with mild stage AD and imply the possible benefits in the advanced stage of AD for relatively preserved long-term memory.
多奈哌齐已被批准用于治疗阿尔茨海默病（AD），且推荐使用较高剂量。然而，一些研究报告称，在未测量浓度的情况下，AD 患者使用多奈哌齐治疗的认知反应存在差异。
我们在 37 名接受多奈哌齐 5mg/d 治疗的新诊断为轻度 AD 的患者中，使用认知能力筛查工具评估了各个认知领域的治疗反应与多奈哌齐血浆浓度之间的关系。
在认知能力筛查工具的 9 个认知领域中，长期记忆领域的改善率最高（81.1%），与其他领域相比。多奈哌齐血浆浓度增加[平均值（SD），75.14（32.16）ng/mL]与长期记忆改善显著相关（P=0.045；比值比，0.959；95%置信区间，0.920-0.999），校正年龄、性别、教育程度和载脂蛋白 E 基因型后。
尽管我们的研究存在一些局限性，但这些发现表明较高浓度的多奈哌齐可改善轻度 AD 患者的长期记忆，并暗示在 AD 的晚期阶段，对于相对保留的长期记忆可能有潜在益处。
