Objective:To evaluate the effectiveness of donepezil to prevent or treat delirium in patients undergoing total joint replacement surgery.
Design: Subjects undergoing elective total hip or knee replacement surgery were randomly assigned to placebo or donepezil 5 mg two weeks prior to their scheduled surgery. Baseline cognitive measures were obtained preoperatively. Patients were then assessed daily after the surgery until discharge and then followed by telephone up to 14 days after surgery. Patients who met criteria for delirium had their dose of placebo or donepezil doubled for the duration of the study.
Materials and Methods: 80 Patients were randomized into the study. Patients were rated using the Delirium Symptom Interview and DSM-IV criteria for delirium.
Results: None of the subjects met criteria for dementia or delirium prior to the surgery. After surgery the rates of delirium differed between the placebo and donepezil groups.
Conclusion: Donepezil appears to have some benefit in reducing the incidence or duration of delirium in this patient population. Unfortunately many patients refused to participate in the study or dropped out because of side effects. There were small differences in dropout rates between the placebo and donepezil groups.
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