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Donepezil induces ventricular arrhythmias by delayed repolarisation

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Abstract

Acetylcholinesterase inhibitors such as donepezil delay the progression of Alzheimer’s dementia by increasing acetylcholine concentrations in the central nervous system. However, it is becoming apparent that cholinesterase inhibition by donepezil is not confined to the brain. This is supported by previous case reports of peripheral cholinergic side effects and adverse cardiac arrhythmias such as Torsades de Pointes which are reversible upon cessation of donepezil. The augmented acetylcholine concentrations and IKr inhibition in cardiomyocytes caused by donepezil are believed to mediate this effect.

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Data availability

The data that supports the findings of the study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Cardiology and Internal Medicine, Frimley Health NHS Foundation Trust, Wexham Park Hospital, Wexham Street, Slough, UK

    Jason Kho, Amit K J Mandal & Constantinos G Missouris

  2. Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK

    Adam Ioannou

  3. University of Cyprus Medical School, Nicosia, Cyprus

    Constantinos G Missouris

Authors
  1. Jason Kho
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  2. Adam Ioannou
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  3. Amit K J Mandal
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  4. Constantinos G Missouris
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Contributions

All authors contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript. The authors declare that all data were generated in-house and that no paper mill was used.

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Correspondence to Jason Kho.

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The authors declare that they have no conflict of interest.

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Kho, J., Ioannou, A., Mandal, A.K.J. et al. Donepezil induces ventricular arrhythmias by delayed repolarisation. Naunyn-Schmiedeberg's Arch Pharmacol 394, 559–560 (2021). https://doi.org/10.1007/s00210-020-02028-4

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  • DOI: https://doi.org/10.1007/s00210-020-02028-4

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