Activitas Nervosa Superior

, Volume 59, Issue 1, pp 19–27 | Cite as

Donepezil for Constipation in Lewy Body Diseases: Four Case Studies

  • Charles M. LepkowskyEmail author
Case Report


In Neurocognitive Disorder with Lewy Body (NCDLB) and Parkinson’s Disease (PD), constipation is an almost universal symptom creating hardship for patients and caregivers. Based on a literature review linking constipation in NCDLB and PD to Lewy Body cholinergic impairment of the enteric nervous system (ENS), it is postulated that the use of the cholinergic agonist Donepezil mightreduce the symptom of constipation. This hypothesis is tested through observation of four patients with NCDLB and PD at different stages of disease progression. When treated with Donepezil, all four patients showed marked reductions in constipation without exacerbation of other symptoms. It is concluded that the use of Donepezil appears to reduce the symptom of constipation in patients at different stages of NCDLB and PD, which might significantly improve the quality of life for patients with these disorders. Further research is encouraged matching subjects for diagnosis, gender, and age.


Neurocognitive Disorder with Lewy Bodies Parkinson’s disease Constipation Donepezil Cholinergic agonist 



The author wishes to acknowledge Robert Harbaugh, M.D., and Erin Presant, D.O., for their collaboration in the care of the patients described in the case studies.

Author Contributions

This paper was written according to the Ethical Principles of the American Psychological Association. Charles M. Lepkowsky, Ph.D. is the sole author of this work, including its conception and design; the acquisition, analysis, and interpretation of data; drafting, writing, and editing; final approval of the version published; and accepts accountability for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Compliance of Ethical standards


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Competing interests

The authors declare that they have no competing interests.


Written consent was provided by each of the four patients described in the case studies to release the clinical information contained therein. Patient identifiers have been kept to a minimum.


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© Springer International Publishing 2017

Authors and Affiliations

  1. 1.Independent PracticeSolvangUSA

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