ประสิทธิผลของโดนิเพซิล ในการลดการเสียความสามารถทางพุทธิปัญญาจากการรักษาด้วยไฟฟ้าในโรคจิตเภท / รัศมน กัลยาศิริ = Efficacy of donepezil in the reduction of cognitive impairment from ECT in schizophrenia / Rasmon Kalayasiri
Objective: To evaluate the efficacy of donepezil in the reduction of cognitive impairment of ECT in comparison to placebo in schizophrenic patients. Method: Prospective clinical study was performed on 20 schizophrenic patients for whom Electroconvulsive therapy (ECT) was the treatment of choice. Patients were assigned to take donepezil or placebo as indicated in block of four orderly. Outcome measurements and efficacy were assessed by Mini Mental State Examination (MMSE), word recall and delay recall subtests from Alzheimer's Disease Assessment Scale (ADAS), digit span and logical memory I, II subtests from Wechsler Memory Scale, reaction time and trailmaking A, B before ECT and after the sixth and twelfth ECT. Results: There was statistically significant reduction in the MMSE (time orientation), delay recall and logical II memory scores in both groups comparing to baseline after 6th and 12th ECT. There was reduction in digit backward score after 2nd, 8th, 10th and 12th ECT and MMSE (object recall) after 12th ECT comparing to baseline in placebo group. Donepezil's MMSE score (object recall after 12th ECT was significantly higher than placebo's. Moreover, there was statistical difference in the prevention of severe cognitive impairment (MMSE<24 for at least one day) between groups (p = 0.0492). However, there was no statistical difference of word recall, delay recall, logical memory I and II, trailmaking A and B, reaction time and digit span scores between groups. Conclusion: The results suggest that Donepezil is effective in the reduction of memory impaiment from ECT in schizophrenic patients after 12th ECt comparing to placebo and has tendency to be effective in the reduction of attention impairment. Moreover, Donepezil is effective in the prevention of severe cognitive impairment from ECT in schizophrenic patients.