Patient/caregiver was instructed upon therapeutic uses and mechanism of action of Donepezil as follows:
- Acetylcholine is one of the various other neurotransmitters in the brain, playing significant role in the functionality of memory and cognition. Acetylcholine produced in the brain binds to receptors called cholinergic receptors, located on the nerve cells. This binding of acetylcholine with the cholinergic receptors leads to stimulation of these receptors and utilization of acetylcholine by the cholinergic neurons promotes learning and memory.
- After the cholinergic neurons utilize the acetylcholine secreted into the synapse, any extra acetylcholine left in the synapse is broken down or hydrolyzed by an enzyme called cholinesterase, to prevent continued persistent activation of the cholinergic receptors, as this can progressively lead to destruction of nervous tissues in the brain.
- Selective loss/destruction of cholinergic neurons in the brain is considered one very important factor that can lead to Alzheimer’s disease. Reduced number of cholinergic neurons contributes to underutilization of acetylcholine in the nervous tissues, reduced cholinergic transmission, and thus leads to signs and symptoms of Alzheimer’s disease, such as, memory loss and cognitive deficits.
- Donepezil is a medication increasing the utilization and activity of acetylcholine in the brain, thus improving the cholinergic neurotransmission.
- Donepezil is believed to inhibit the activity of the enzyme cholinesterase in the brain, thus inhibiting the breakdown of acetylcholine in the synapse. Thus, higher concentration of acetylcholine is left in the synapse, to bind to the receptors and activate the cholinergic neurons.
- This will contribute to improved utilization of acetylcholine and cholinergic neurotransmission, which helps improve the signs and symptoms of Alzheimer’s disease, such as, memory loss and cognitive deficits. So, donepezil is used in the treatment of dementia and Alzheimer’s disease.
