Donepezil and related cholinesterase inhibitors as mood and behavioral controlling agents.
Acetylcholinesterase inhibitors (ChEIs) enhance neuronal transmission by increasing the availability of acetylcholine in muscarinic and nicotinic receptors. This effect is believed to be responsible for the beneficial and protective effects of ChEIs on cognition in patients with Alzheimer's disease (AD). Effects of ChEIs on mood and behavior have also been reported. Earlier observations were limited by the exclusive availability of intravenous forms of administration, the short half-life of the formulations, and the high frequency of peripheral side effects. The introduction, in recent years, of better tolerated and less invasive compounds has rekindled the interest in cholinergic central nervous system mechanisms and has given rise to studies in areas other than cognition. The ChEI donepezil has been involved in the largest number of studies and positive reports. Preliminary observations suggest the possible value of ChEIs in the management of behavioral dysregulation, apathy, irritability, psychosis, depression, mania, tics, and delirium and in the diagnosis of depression, panic, and personality disorders.
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Assistant Professor of Psychiatry and Behavioral Sciences
Tal Burt, MD is a Board-Certified psychiatrist and clinical researcher trained in Israel, Italy, France, and the United States. After joining the faculty at the Department of Psychiatry at Columbia University, Dr. Burt joined Pfizer Inc., and then Eisai Pharmaceuticals, as Senior Medical Director with responsibilities in all phases of clinical research and development. He then joined Duke and was the founding director of the Investigational Medicine Unit (IMU) in Singapore and th