, Volume 34, Issue 9, pp 1685-1686
Date: 23 Nov 2012

Donepezil induced antecollis in a patient with Parkinson’s disease dementia

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Dear Editor,

Donepezil hydrochloride is a widely prescribed drug for Alzheimer’s disease (AD) and is also beneficial for patients with Parkinson disease dementia (PDD) [1]. Donepezil improves cognition by enhancing central cholinergic transmission in the brain of patients with AD [1]. It is a relatively safe drug, with rare neuropsychiatric side-effects [2], and only a few cases of extrapyramidal symptoms have been reported [37].

We experienced a 79-year-old female patient with Parkinson’s disease, who developed antecollis after prescribing donepezil hydrochloride. At the age of 75 years, she visited another hospital because of a 3 month history of shaking movements in her right hand. The initial examination showed hypomimia, bradykinesia, rigidity, and resting tremors of the right hand. She scored 1.5 on the modified Hoehn and Yahr stage, and was treated with 250 mg levodopa twice per day. During the subsequent 2 years, motor symptoms were optimized, and her clinical condition remained