Heart rate variability is used to assess cardiovascular autonomic function. The cholinesterase inhibitor donepezil potentially affects parasympathetic activity. Twenty participants with Alzheimer's disease of dementia with Lewy bodies were treated with donepezil in a pilot study. Power spectral analysis was used to analyse 5 min of beat-to-beat RR interval in 15 case. Heart rate variability was significantly reduced following treatment with donepezil; mainly for high frequency (median changed from 581 to 78 ms²; p=0.001) but also for total power (median changed from 1,563 to 844 ms²; p=0.047). Donepezil may adversely influence cardiovascular autonomic control. These results indicate the need for larger controlled trials to further investigate the cardiovascular effects of donepezil.
McLaren AT, Allen J, Murray A, Ballard CG, and Kenny RA. Cardiovascular effects of Donepezil in patients with dementia. Dementia and Geriatric Cognitive Disorders 2003; 15(4):183-188.
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