Donepezil and α‐synuclein Constipation: A 60 Month Follow-Up

Abstract

In a longitudinal case study, the acetylcholinesterase inhibitor (AChEI) Donepezil was used to address the symptoms of constipation, obstipation and impaction in four patients diagnosed at different stages of disease progression with the α‐synuclein or Lewy body disorders Parkinson’s disease (PD) and Neurocognitive Disorder with Lewy Bodies (NCDLB). For each of the four patients, the use of Donepezil was associated with significant symptom reduction. Symptom improvement was maintained in follow-up studies conducted at intervals of six, twelve, eighteen, thirty-six, forty-eight and sixty months, with no apparent reduction in bowel motility. After four or five years, even with progression of other α‐synucleinopathy, bowel motility was preserved. The results suggest that patients with α‐synuclein disorders can experience long-term benefit in the reduction of symptoms including constipation, obstipation and impaction with the use of the AChEI Donepezil. Keywords: Neurocognitive Disorder with Lewy Bodies, Parkinson’s disease, constipation, Donepezil, acetylcholinesterase inhibitor