Disclosures: Mina S. Gayed, DO: No financial relationships or conflicts of interest

Background and/or Objectives: Aggregate and assess current literature regarding benefits or lack thereof on the use of donepezil in traumatic brain injury (TBI).

Design: Systematic Review

Setting: University Hospital

Participants: A literature search on PubMed using the keywords “Donepezil” and “brain injury” resulted in 53 articles. Of the 53 articles, 12 were excluded and 41 were included in the final systematic review that met objective criteria.

Interventions: N/A

Main Outcome Measures: Summarize via systematic analysis of published studies results regarding the benefits or detriments of the use of Donepezil for TBI.

Results: Most common benefits in patients included improved focus, attention, social engagement, energy, decreased apathy, and improved visual processing. Most common benefits in patients included improved focus, attention, social engagement, energy, decreased apathy, and improved visual processing. Significant benefits were seen in many studies at just the 5 mg dose with the 10 mg dosing showing increased incidence of untoward side effects. Persistent benefits were seen even with the washout of Donepezil. In animal studies, the use of Donepezil was generally not as promising likely due to several factors including differences in dosing schemes and formal testing methods.

Conclusions: Donepezil may be useful for individuals with TBI. Although it is classically known for improvement of memory impairments, the available literature suggests that this may not be the case in the traditional sense. It may help memory indirectly as a result of improvement in general functioning. Donepezil appears to be beneficial for general quality of life as it improves mood, energy, visual processing ability, and attention to tasks. Some studies inferred that Donepezil may have a neuroprotective or anti-inflammatory effect on hippocampal neurons. This could have some utility for identifying an optimal time to initiate Donepezil in acute TBI and presents an exciting prospect for future studies.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-use-of-donepezil-in-traumatic-brain-injury-a-systematic-review/