Donepezil slightly improves several cognitive functions in brain tumor survivors who have undergone irradiation, although it does not significantly improve overall composite score, according to a Journal of Clinical Oncology study published online ahead of print.

Researchers led by Stephen R. Rapp, PhD, of Wake Forest University School of Medicine examined 198 adult brain tumor survivors at least 6 months after partial- or whole-brain irradiation who were randomly assigned to single daily dose of donepezil or placebo. Cognitive composite score and individual cognitive domains were evaluated.

Among these patients, who were mostly middle-aged, married, non-Hispanic and white, 66 percent had primary brain tumors, 27 percent had metastases, and eight percent underwent prophylactic cranial irradiation.

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After 24 weeks, composite scores did not significantly differ between the two treatment groups. However, there were significant differences favoring donepezil in memory, and motor speed and dexterity.

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The benefit donepezil was greater among those patients who were more cognitively impaired before the study, particularly in immediate recall, delayed recall, attention, visuomotor skills, and motor speed and dexterity.

“Treatment with donepexil did not significantly improve the overall composite score, but it did result in modest improvements in several cognitive functions, especially among patients with greater pretreatment impairments,” the authors concluded.


  1. Rapp, Stephen R., et al. “DonepexiL for Irradiated Brain Tumor Survivors: A Phase III Randomized Placebo-Controlled Clinical Trial.” Journal of Clinical Oncology. doi: 10.1200/JCO.2014.58.4508. [epub ahead of print]. April 20, 2015.