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What is the role of the tablet Donepezil in improving the memory of an elderly female?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I care for my mother, who has CHF (congestive heart failure), sleep apnea, and dementia. Her procedural memory was worsening a few months ago. She has been taking the tablet Donepezil 5 mg at night for the last ten weeks. In the previous few weeks, her procedural memory has improved. She is more functional and independent. Some people think it would be central sleep apnea. Has her memory improved due to the tablet Donepezil 5 mg? She also met with an accident a week ago. What is your opinion on all this now?
Answered by Dr. Aida Abaz Quka

Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

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Hello,

Welcome to icliniq.com.

You should know that you can increase the dose of the tablet Donepezil to 20 mg daily. So, 5 mg is quite a small dose. As Donepezil improves sleep apnea, too, I think we can wait for more benefits by increasing its dose.

Patient's Query

Thank you doctor for the reply,

She is already taking Donepezil 5 mg daily at night. Will the risk of diarrhea increase if I increase the dose? It appears the drug has helped her. I shall say that her apnea was much better, but her functioning was still poor. Can medicine play an important role in preventing her from getting worse at this point?

Answered by Dr. Aida Abaz Quka

Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Hello,

Welcome back to icliniq.com.

This drug is usually given once a day at bedtime as it can cause sleepiness. This drug can help improve her situation, but it does not stop the disease progression.

Patient's Query

Dr Q So doctor approved to 10mg. I have bumped it up to 7.5mg for 1 week. Tonight she got 10mg and felt quite nauseated going into bedtime. Though diarrhea incidents are not common - she has more headaches in general and the nauseated feeling was strong tonight. She already takes Burinex 1 to 2mg daily and that causes stomach upset even with 2 tecta daily and 3 gavescons. Will have to figure dosing better out. The drug definitely helped her procedural memory. She has a PSW coming in who states she has patients who both physically and mentally abuse her. My mother only has lapses in basic procedural processes - her rationale skills are still good. The reality is she will be 96 in two months and imagine her heart will give out before her brain. I just wish to give her comfort and dignity as Canadian healthcare being free is dismal as its abused gnite
Answered by Dr. Aida Abaz Quka

Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
Hello again! Thank you for the information! I recommend trying to be patient and wait for her to get used to this dose. If in a week she continues being nauseous, I recommend going back to the dose 7.5 mg daily. Hope you will find this information helpful! Wishing all the best, Dr. Aida

Patient's Query

Dr Quka: I shall close this question after this last feedback. Anyhow in latter August - the drug was increased to 10mg. Other than a few days (3 to 4) - she remained at that dosage because of diarrhea accidents. Dont know if it was directly the drug. Anyhow, she began the 5mg all the way back in latter June. I have attached the AHI chart. By the end of July - it had dropped down to 2. Her procedural memory stabilized and it was pretty good for a number of daily tasks being more independent. Now if you look at the September chart, although being on 10mg - her AHI has increased - hitting the teens to 20s a few days in a row. She has had now 2 of the last 3 nights where she woke up in the morning where she didnt know where she was. She collects herself and is better as the morning goes on. So whether its the drug or the sleep a few months ago led to the improved memory? You already inferred 20mg as well. Whether the GP will approve or will it work? She had a number of urinary accidents in mid summer. She began 25mg mirabegron. It had helped reduce the accidents significantly. Now the last couple of weeks - accidents have increased again. An online urologist recommended 50mg. She has been on it as well now a few days and accidents are down. He inferred if it works - its the bladder. If it doesnt, its her dementia. Your thoughts on this now - thanks
Answered by Dr. Aida Abaz Quka

Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Hello! I am glad that she is better now! I don’t think that increasing donepezil dose will help improve her urination. I think that mirabegron is the best option for this issue. Hope you will find this information helpful!

Patient's Query

How much extra benefit would occur with 20mg donepezil than 10 which includes side effects. For memory not urination, would you wait for 2 months for benefit if increased from 5 to10
Answered by Dr. Aida Abaz Quka

Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
It could lead to diarrhoea or increased urination, because of the colinergig effects. That is why I don’t recommend increasing the dose further.
Medically reviewed by iCliniq medical review team
Published At August 20, 2022
Reviewed At June 14, 2023

Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Aida Abaz Quka
Dr. Aida Abaz Quka

Neurology

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Education:

Faculty of Medicine

Professional Bio:

Dr. Aida Abaz Quka is a Neurologist with 12 years of experience. She completed her studies at the Faculty of Medicine and pursued a Neurology Post Graduation. Specializing in diagnosing and treating neurological disorders, she offers expert care for conditions affecting the nervous system.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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