Key result
Long-term donepezil therapy significantly prolonged the QT interval compared to baseline (P=0.002), resulting in 13.6% of patients developing high arrhythmogenic risk.
Why the study?
The potential side effects of donepezil on cardiac conduction remain unclear, particularly its effects on the QT interval.
Does long-term donepezil therapy prolong the QT interval in patients?
Observational (n=59)
No
Does long-term donepezil therapy prolong the QT interval in patients?
Long-term donepezil therapy significantly prolongs the QT interval, suggesting a need for ECG monitoring, particularly when co-prescribed with tricyclic antidepressants.
Answers are grounded in this paper and cite their sources.
May prompt ECG monitoring with long-term donepezil; leaves open arrhythmia event rates in broader populations.
Background and Purpose: The neurocognitive benefits of donepezil are well recognised, but the potential side effects on cardiac conduction remain unclear. Our objectives are to investigate whether long-term donepezil therapy is associated with electrocardiographic (ECG) changes and in particular to assess its effects on the QT interval. Experimental approach: We conducted a single centre retrospective analysis of patients admitted to our institution on donepezil therapy over a 12-month period. 59 patients were identified as suitable for analysis. An admission resting 12-lead ECG was obtained and compared to their ECG prior to commencement of donepezil therapy to assess for any significant difference in ECG parameters. Key Results: Donepezil significantly prolonged the PR (P=0.04), QRS (P=0.04) and QT (P=0.002) intervals. The increase in QT intervals remained significant on correction for heart rate; resulting in 8 (13.6%) patients developing high arrhythmogenic risk based on assessment using QT nomogram plots. Concomitant use of tricyclic antidepressants was associated with significant QT prolongation, while use of rate limiting calcium channel blockers was associated with significant PR prolongation, and beta-blockers with reduction in heart rate. Conclusion and Implications: Our results clearly demonstrate that long-term use of donepezil results in prolongation of the QT interval. We suggest ECG evaluation should take place before and after donepezil initiation, and clinicians should be even more vigilant in those prescribed tricyclic antidepressants.
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Kho et al. (2020) reported an observational. Long-term donepezil therapy vs. Baseline ECG prior to donepezil therapy was evaluated on Difference in ECG parameters (PR, QRS, and QT intervals) (p=0.002). Long-term donepezil therapy significantly prolonged the QT interval compared to baseline (P=0.002), resulting in 13.6% of patients developing high arrhythmogenic risk.
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