Correlation Between Donepezil and QTc Prolongation and Torsades de Pointes: A Very Rare Phenomenon

Abstract

Dementia can be seen as a clinical syndrome featuring a decline in cognitive and psychological abilities that can cause disability. Two major kinds of drugs are available: N-methyl-D-aspartic acid receptor antagonists like memantine and acetylcholinesterase inhibitors such as galantamine, rivastigmine and donepezil. In this article, we have reviewed the available literature along with the provision of a snapshot of published cases in the literature We used the PubMed database for our search. The average age of patients was 80 years and above. Patients described in the literature belonged to both female and male gender, with female patients being predominant. Patients demonstrated associated atrioventricular (AV) block or ventricular premature contractions (VPC) or atrial fibrillation (AF) prior to developing torsades de pointes (TdP). Presenting complaints were either syncope or diarrhoea or accidental bradycardia. Mostly, the corrected QT interval (QTc) normalisation was associated with discontinuation of donepezil. We recommend further studies to determine this correlation between donepezil and incidence of QTc prolongation and TdP.