Can Aricept be stopped abruptly?
Do not stop taking Aricept (donepezil) without consulting your healthcare provider. If you stop taking Aricept abruptly, your Alzheimer’s disease symptoms can worsen. It is generally recommended to slowly taper down your dose of Aricept before stopping completely. Your doctor can help you stop Aricept safely.
During a 30-week clinical trial, patients took Aricept for 24 weeks followed by 6 weeks of a placebo (sugar pill). During the 6 weeks of taking no medication that followed the first 24 weeks of treatment, researchers found that the beneficial effects of Aricept were lost after patients stopped taking it.
Another study of patients who took Aricept for 12 weeks followed by 3 weeks of taking a placebo concluded the same thing. The effects of Aricept were lost after patients stopped taking the medication. This was demonstrated by an increase in Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) scores, which evaluates memory and language skills.
One small study of patients who took Aricept for one year and then stopped taking it showed that abrupt discontinuation of the medication did not lead to withdrawal symptoms. However, there are a few case reports of patients who stopped taking Aricept abruptly and developed delirium, increased anxiety, difficulty sleeping, and worsening dementia symptoms. These symptoms went away after starting Aricept again.
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When to stop taking Aricept
There are some situations where you may need to stop taking Aricept. Some examples include:
- Allergic reaction
- The medication is not providing any benefit for Alzheimer's disease
- Side effects are too bothersome
- Interaction with other medications
It is best to talk to your prescriber before stopping Aricept abruptly, but in some cases you may need to stop it right away. One example is if you are having a bad allergic reaction. If you think you’re having an allergic reaction to Aricept, stop taking it and tell your doctor right away. Get immediate medical attention if the reaction is severe (e.g., swelling in your face, trouble breathing, fast heart rate).
If possible, consult with your doctor before stopping Aricept. Do not try to lower the dose on your own. Your doctor can help you come up with a plan to stop taking Aricept safely. During the first weeks after stopping Aricept, they will also monitor you to make sure you aren’t having worsening symptoms of Alzheimer’s disease or other problems from stopping the medication. If you do start having more symptoms, they may need to restart Aricept and try to gradually lower the dose again.
References
Bidzan, L., et. al. (2012). Withdrawal syndrome after donepezil cessation in a patient with dementia. In: Neurological Sciences. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506829/
Burns, A., et al. (1999). The effects of donepezil in Alzheimer's disease - results from a multinational trial. In: Dementia and Geriatric Cognitive Disorders. Available from: https://pubmed.ncbi.nlm.nih.gov/10325453/
Donepezil tablet [package insert]. (Revised April 2023). Camber Pharmaceuticals, Inc. Accessed 06/14/2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=11ac01f4-d26e-47b2-9660-d514ab097fdb
Howard, R., et. al. (2012). Donepezil and Memantine for Moderate-to-Severe Alzheimer's Disease. In: The New England Journal of Medicine. Available from: https://pubmed.ncbi.nlm.nih.gov/22397651/
Kueper, J., et. al. (2018). The Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog): Modifications and Responsiveness in Pre-Dementia Populations. A Narrative Review. In: Journal of Alzheimer’s Disease. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929311/
Reeve, E., et. al. (2019). Deprescribing cholinesterase inhibitors and memantine in dementia: guideline summary. In: The Medical Journal of Australia. Available from: https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50015
Rogers, S. L., et. al. (1998). Donepezil Improves Cognition and Global Function in Alzheimer Disease: A 15-Week, Double-blind, Placebo-Controlled Study. In: JAMA. Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/205223
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Drug information
- Aricept Information for Consumers
- Aricept prescribing info & package insert (for Health Professionals)
- Side Effects of Aricept (detailed)
Related support groups
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