The THE EFFECT OF DONEPEZIL ON THE IMPROVEMENT OF COGNITIVE FUNCTION AND PLASMA BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) LEVELS IN SCHIZOPHRENIA
Main Article Content
Keywords
Schizophrenia, Donepezil, Risperidone, Cognitive Function, BDNF
Abstract
Abstract
Background : Donepezil administration as adjuvant therapy in schizophrenic patients is considered to improve cognitive function and is associated with increased levels of BDNF which has been widely studied as a cognitive marker for schizophrenia. The purpose of this study was to determine the effect of Donepezil on the improvement of cognitive function and plasma BDNF levels in patients with schizophrenia.
Objective : To determine the effect of adjuvant therapy of donepezil in improving cognitive function and BDNF levels in schizophrenic patients receiving risperidone.
Method : Forty-four (44) schizophrenia inpatient were divided into two groups, the research group, and the control group. Both groups received Risperidone 4 mg/day, and only the treatment group was received 5 mg donepezil for 6 weeks. To assess cognitive function, the SCoRS v BI scale was used and plasma BDNF levels were measured. Independen t tests, Wilcoxon, Friedman and Spearman correlation tests were performed to assess the difference means between groups.
Results : There was a significant improvement in cognitive function in both groups (p<0.05). Although there was an increase in plasma BDNF levels in both groups, only research group was statistically significant at (p<0.05). The comparison of changes in the SCoRS v BI scores, plasma BDNF levels and in the correlation in both group was significant (p <0.05).
Conclusion The addition of adjuvant therapy donepezil to standard therapy Risperidone 4 mg/day was associated with improved cognitive function and also associated with increased plasma BDNF levels.
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Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar. 2018
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Departemen Kesehatan Republik Indonesia. Pedoman Penggolongan dan Diagnosis Gangguan Jiwa di Indonesia III (PPDGJI-III). Jakarta, 1993 : 105-115.
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Aricept®Oral Solution (Donepezil Hydrochloride). Available from http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/217191bl.
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Xu, H., Wang, J., Zhou, Y., Chen, D., Xiu, M., Wang, L., & Zhang, X. (2021). BDNF affects the mediating effect of negative symptoms on the relationship between age of onset and cognition in patients with chronic schizophrenia. Psychoneuroendocrinology, 125. https://doi.org/10.1016/j.psyneuen.2020.105121
Vita, A., Deste, G., Barlati, S., de Peri, L., Giambra, A., Poli, R., Keefe, R. S. E., & Sacchetti, E. (2013). Interview-based assessment of cognition in schizophrenia: Applicability of the Schizophrenia Cognition Rating Scale (SCoRS) in different phases of illness and settings of care. Schizophrenia Research, 146(1–3), 217–223. https://doi.org/10.1016/j.schres.2013.02.035
Ardiningrum, W., Marchira, C. R., Kristanto, C. S., Ismanto, S. H., & Primawati, S. (2019). Uji Validitas dan Reliabilitas Cognitive Assessment Interview versi Indonesia. Cermin Dunia Kedokteran, 46(5), 327-333.
Tuǧal, Ö., Yazici, K. M., Yaǧcioǧlu, A. E. A., & Göǧüş, A. (2004). A double-blind, placebo controlled, cross-over trial of adjunctive donepezil for cognitive impairment in schizophrenia. International Journal of Neuropsychopharmacology, 7(2), 117–123. https://doi.org/10.1017/S1461145703004024
Thakurathi, N., Vincenzi, B., & Henderson, D. C. (2013). Assessing the prospect of donepezil in improving cognitive impairment in patients with schizophrenia. Expert Opinion on Investigational Drugs, 22(2), 259–265. https://doi.org/10.1517/13543784.2013.750650
Terry, A. v., & Mahadik, S. P. (2007). Time-dependent cognitive deficits associated with first and second generation antipsychotics: Cholinergic dysregulation as a potential mechanism. In Journal of Pharmacology and Experimental Therapeutics (Vol. 320, Issue 3, pp. 961–968). https://doi.org/10.1124/jpet.106.106047
Yoo, J. H., Valdovinos, M. G., & Williams, D. C. (2007). Relevance of donepezil in enhancing learning and memory in special populations: A review of the literature. In Journal of Autism and Developmental Disorders (Vol. 37, Issue 10, pp. 1883–1901). https://doi.org/10.1007/s10803-006-0322-8
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Shrivastava, A. K., & Johnston, M. E. (2010). Cognitive neurosciences: A new paradigm in management and outcome of schizophrenia. In Indian Journal of Psychiatry (Vol. 52, Issue 2, pp. 100–105). https://doi.org/10.4103/0019-5545.64575
Sangiovanni, E., Brivio, P., Dell’Agli, M., & Calabrese, F. (2017). Botanicals as Modulators of Neuroplasticity: Focus on BDNF. Neural Plasticity, 2017. https://doi.org/10.1155/2017/5965371
Harvey, P. D., & Sand, M. (2017). Pharmacological augmentation of psychosocial and remediation training efforts in schizophrenia. In Frontiers in Psychiatry (Vol. 8, Issue SEP). Frontiers Media S.A. https://doi.org/10.3389/fpsyt.2017.00177
Mishara, A. L., & Goldberg, T. E. (2004). A meta-analysis and critical review of the effects of conventional neuroleptic treatment on cognition in schizophrenia: Opening a closed book. Biological Psychiatry, 55(10), 1013–1022. https://doi.org/10.1016/j.biopsych.2004.01.027
Kotani, S., Yamauchi, T., Teramoto, T., & Ogura, H. (2008). Donepezil, an acetylcholinesterase inhibitor, enhances adult hippocampal neurogenesis. Chemico-Biological Interactions, 175(1–3), 227–230. https://doi.org/10.1016/j.cbi.2008.04.004
Carlino, D., de Vanna, M., & Tongiorgi, E. (2013). Is altered BDNF biosynthesis a general feature in patients with cognitive dysfunctions? Neuroscientist, 19(4), 345–353. https://doi.org/10.1177/1073858412469444
Buchanan, R. W., Summerfelt, A., Tek, C., & Gold, J. (n.d.). An open-labeled trial of adjunctive donepezil for cognitive impairments in patients with schizophrenia. www.elsevier.com/locate/schres
Ahmed, A. O., & Bhat, I. A. (2014). Psychopharmacological treatment of neurocognitive deficits in people with schizophrenia: A review of old and new targets. In CNS Drugs (Vol. 28, Issue 4, pp. 301–318). Springer International Publishing. https://doi.org/10.1007/s40263-014-0146-6
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Favalli, G., Li, J., Belmonte-de-Abreu, P., Wong, A. H. C., & Daskalakis, Z. J. (2012). The role of BDNF in the pathophysiology and treatment of schizophrenia. Journal of Psychiatric Research, 46(1), 1–11. https://doi.org/10.1016/J.JPSYCHIRES.2011.09.022
Rogers, S. L., & Friedhoff, L. T. (1998). Pharmacokinetic and pharmacodynamic profile of donepezil HCl following single oral doses. In Br J Clin Pharmacol (Vol. 46).
Gomolin, I. H., Smith, C., & Jeitner, T. M. (2011). Donepezil Dosing Strategies: Pharmacokinetic Considerations. Journal of the American Medical Directors Association, 12(8), 606–608. https://doi.org/10.1016/j.jamda.2011.02.004
Freudenreich, O., Herz, L., Deckersbach, T., Evins, A. E., Henderson, D. C., Cather, C., & Goff, D. C. (2005). Added donepezil for stable schizophrenia: A double-blind, placebo-controlled trial. Psychopharmacology, 181(2), 358–363. https://doi.org/10.1007/s00213-005-2235-1
Nieto, R., Kukuljan, M., & Silva, H. (2013). BDNF and schizophrenia: From neurodevelopment to neuronal plasticity, learning, and memory. In Frontiers in Psychiatry (Vol. 4, Issue JUN). https://doi.org/10.3389/fpsyt.2013.00045
Keefe, R. S. E., Malhotra, A. K., Meltzer, H. Y., Kane, J. M., Buchanan, R. W., Murthy, A., Sovel, M., Li, C., & Goldman, R. (2008). Efficacy and safety of donepezil in patients with schizophrenia or schizoaffective disorder: Significant placebo/practice effects in a 12-week, randomized, double-blind, placebo-controlled trial. Neuropsychopharmacology, 33(6), 1217–1228. https://doi.org/10.1038/sj.npp.1301499
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Jul 27, 2023
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Lisal T Sonny, Lompi Fadillah Aulya, Hawaidah, Bahar Burhanuddin, Limoa Erlyn, Tammasse Jumraini, & Syamsuddin Saidah. (2023). The THE EFFECT OF DONEPEZIL ON THE IMPROVEMENT OF COGNITIVE FUNCTION AND PLASMA BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) LEVELS IN SCHIZOPHRENIA. Journal of Population Therapeutics and Clinical Pharmacology, 30(16), 397–407. https://doi.org/10.53555/jptcp.v30i16.1855
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Author Biographies
Lisal T Sonny
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
Lompi Fadillah Aulya
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
Hawaidah
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
Bahar Burhanuddin
Department of Public Health, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
Limoa Erlyn
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
Tammasse Jumraini
Department of Neurology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
Syamsuddin Saidah
Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.