The effectiveness of donepezil for cognitive rehabilitation after traumatic brain injury: a systematic review.

Abstract

We systematically reviewed all the published evidence concerning the efficacy and safety of acetylcholinesterase inhibitors (AChEIs) for the rehabilitation of cognitive impairments after TBI. Preliminary searches on electronic databases indicated that donepezil was practically the only new AChEI for which such information was available. Therefore, we singled out donepezil and undertook a systematic review on its efficacy and safety in patients with TBI. We searched, PubMed, PsyclNFO, and CENTRAL. The search strategy included both free text and appropriate thesaurus terms for the key words "traumatic brain injury" and "donepezil." To summarize, our review of the literature on the use of donepezil for the treatment of cognitive impairments sustained after TBI suggests the possibility of its efficacy, but does not drive us to support its use uncritically. The bottom line is that the effectiveness of donepezil on cognitive rehabilitation after TBI remains uncertain owing to the scarce evidence so far obtained, and the poor methodological quality of the studies. This discrepancy could be the result of the different TBI populations assessed in the different trials, the different time window in the prescription of donepezil, or other characteristics such as maximum daily dosage attained for donepezil. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

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