Will donepezil (Aricept) side effects cause mental symptoms such as mania?

Donepezil is an acetylcholinesterase inhibitor mainly used to improve cognitive function in patients with mild to moderate Alzheimer's disease (AD). It improves cognitive and memory functions by inhibiting the breakdown of acetylcholine and increasing the concentration of acetylcholine across nerve synapses. However, like all CNS-acting drugs, some neuropsychiatric side effects may occur during use of donepezil, including changes in mood and behavior.

Clinical research and medication experience show that common adverse reactions of donepezil include nausea, vomiting, diarrhea, insomnia and headache. For a small number of patients, especially elderly patients or those with fragile mental foundations, anxiety, agitation, mood swings, and even temporary mental abnormalities may occur. These symptoms are often related to the central cholinergic effects of the drug, as excessive or sensitized cholinergic stimulation may affect mood-regulating networks in the brain.

Although manic mood or psychotic symptoms are uncommon during donepezil treatment, if they occur, they require close monitoring and prompt intervention. Doctors may adjust the dose, extend the dose escalation time, or consider temporarily discontinuing the drug based on the patient's specific conditions, while investigating other factors that may cause psychiatric symptoms, such as underlying mental illness, concomitant medications, or metabolic abnormalities. Often, these psychiatric symptoms resolve when the drug is discontinued or the dose is adjusted.

Overall, donepezil does have the potential to cause mania or other psychiatric symptoms in a small number of patients, but the overall incidence is low. Patients and their families should pay attention to observe changes in abnormal emotions or behaviors during medication and maintain communication with their doctors. With reasonable dose adjustment and follow-up monitoring, donepezil remains a safe and effective cognitive-improving drug for Alzheimer's disease.

Reference link:https://www.drugs.com