Suspected donepezil withdrawal syndrome in an older woman with Alzheimer disease of abrupt cessation: A case report

Table 3 Selected published reports of cognitive or behavioural deterioration after cholinesterase-inhibitor discontinuation, compared with the present case

Ref.	Age/sex	Drug/daily dose	Duration before stop	Onset after stop	Outcome after restart/withdrawal
Singh and Dudley[6]	77 male/79 female	Donepezil 10 mg/5 mg	Approximately 1 year/3 years	Within days	Improved within days after donepezil 5 mg
Bidzan and Bidzan[7]	62 female (Alzheimer disease)	Donepezil	Approximately 1 year	After discontinuation; delirium developed	Delirium resolved and mental state stabilized after restart
Greiman et al[8]	83 female (DLB)	Donepezil 10 mg; abrupt switch/discontinuation	Not clearly stated in report	Rapid cognitive/functional decline	Improved after restoration of cholinesterase-inhibitor therapy
Minett et al[9]	DLB/PDD; 19 patients	Donepezil up to 10 mg/day	20 week treatment; 6-week withdrawal	During withdrawal	Loss of cognitive treatment gains and behavioural deterioration; improvement after recommencement
Present case	89 female (Alzheimer disease)	Donepezil 10 mg	> 5 years	2 days	CAM-positive delirium/behavioural syndrome; improvement after 5 mg restart

DLB: Dementia with Lewy bodies; PDD: Parkinson disease dementia; CAM: Confusion assessment method.