The effects of donepezil on clinical symptoms, language, and executive skills in individuals with autism spectrum disorder (ASD); A systematic Review

Abstract

This systematic review assesses the potential efficacy of donepezil in treating autism spectrum disorder (ASD), a neurodevelopmental condition characterized by social communication difficulties and repetitive behaviors. Donepezil, an acetylcholinesterase inhibitor primarily used for Alzheimer's disease, has gained attention as a potential treatment for ASD symptoms. Methods: Following PRISMA guidelines, we conducted a systematic review of studies investigating donepezil's effects on individuals with ASD. The study types included randomized controlled trials (RCTs), retrospective studies, open-label trials, and case reports. Outcome measures assessed various aspects of ASD, including language skills, executive function, behavior, and core symptoms. Results: Nine studies were identified, consisting of four RCTs, three retrospective studies, one open-label trial, and one case report. The findings were diverse, with some studies suggesting potential benefits of donepezil in specific domains. One RCT reported significant improvements in expressive and receptive language skills, especially in younger children. Another study combining donepezil with choline supplementation showed enhanced receptive language skills, particularly in younger participants. An open-label trial indicated improved REM sleep patterns in autistic children treated with donepezil. Several retrospective studies reported improvements in behavioral symptoms, such as aggression and hyperactivity. However, other RCTs did not find statistically significant improvements in executive functioning.