Donepezil for α‐synuclein Constipation: An 18 Month Follow-Up

Abstract

In a series of case studies, four patients diagnosed with the α‐synuclein or “Lewy body” disorders Parkinson’s disease (PD) and Neurocognitive Disorder with Lewy Bodies (NCDLB) at different stages of disease progression were treated for the symptoms of constipation, obstipation, and impaction with the acetylcholinesterase inhibitor (AChEI) Donepezil. Initial findings indicated that the use of Donepezil was associated with significant symptom reduction. The symptom status of each of the four patients was reviewed at six and twelve month intervals, with no apparent reduction in bowel motility, nor the emergence of any new symptoms. After eighteen months, the symptom status of each of the four patients was again assessed. Evaluation of the results suggests that the AChEI Donepezil may have long-term benefit for relieving the symptoms of constipation, obstipation and impaction in patients with α‐synuclein disorders. Keywords: Neurocognitive Disorder with Lewy Bodies, Parkinson’s disease, constipation, Donepezil, acetylcholinesterase inhibitor