Long-term efficacy of donepezil for relapse of visual hallucinations in patients with dementia with Lewy bodies.

Background: The use of cholinesterase inhibitors is recommended for the treatment of dementia with Lewy bodies (DLB) in the guidelines of the DLB Consortium. However, no consensus regarding therapeutic approaches for DLB-related visual hallucinations has been reached. To the best of our knowledge, an appropriate dose of donepezil for the treatment of DLB at each stage has not been discussed.

Methods: Eight patients suffering from DLB with visual hallucinations were treated with donepezil. We summarize the effects of donepezil on these visual hallucinations chronologically in all cases and discuss its efficacy and characteristics.

Results: Donepezil contributed to the complete disappearance of visual hallucinations in all cases, and its effects were maintained for more than 6 months. However, relapses of visual hallucinations also occurred in all cases. Against these relapses, an increased dose of donepezil was very effective in resolving them again in almost all cases in this study.

Conclusions: Donepezil was highly effective against visual hallucinations in DLB patients, but there were some issues regarding pharmacotherapy for DLB.