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The effect of donepezil on sedation and other symptoms in patients receiving opioids for cancer pain: a pilot study

Eduardo Bruera, Florian Strasser, Loren Shen, J Lynn Palmer, Jie Willey, Larry C Driver & Allen W Burton

abstract Opioid-induced sedation is a major complication in patients with cancer pain. This study assessed the effectiveness of donepezil in opioid-induced sedation and related symptoms in patients with cancer pain. Twenty-seven patients who were receiving strong opioids for pain and reported sedation were enrolled. Donepezil 5 mg was given every morning for 7 days. Changes between baseline and Day 7 in sedation, pain, fatigue and other symptoms were evaluated using the Edmonton Symptom Assessment Scale. Fatigue was also measured using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). Overall usefulness of donepezil was measured by the patient at the end of the study. In 20 evaluable patients, sedation, fatigue, anxiety, well-being, depression, anorexia and problems with sleep were significantly improved. Side effects included nausea, vomiting, diarrhea, muscle and abdominal cramps, and anorexia. Overall, however, the treatment was well tolerated. Donepezil appears to improve sedation and fatigue in patients receiving opioids for cancer pain. Randomized controlled trials of this agent are justified.
   
citation Bruera E, Strasser F, Shen L, Palmer J L, Willey J, Driver L C, Burton A W. The effect of donepezil on sedation and other symptoms in patients receiving opioids for cancer pain: a pilot study. Journal of pain and symptom management 2003; 26:1049-54.
   
type journal paper/review (English)
date of publishing 11-2003
journal title Journal of pain and symptom management (26/5)
ISSN print 0885-3924
pages 1049-54
PubMed 14585555