Omitting donepezil is hardly a hardship

doi:10.1136/bmj.39388.433137.1F

BMJ 2007;335:954 (10 November), doi:10.1136/bmj.39388.433137.1F

Letters

NICE on dementia

Omitting donepezil is hardly a hardship

The first 100% of the full text of this article appears below.

To condemn the National Institute for Health and Clinical Excellence(NICE) as ageist when it limits access to donepezil is to fallfor the vendor's advertising and sponsored trials.¹ There isreally no evidence that donepezil does anyone any good. Twoproper randomised clinical trials that are not sponsored bythe vendors show there is no benefit whatsoever to this drug.²³

In particular, neither carers nor patients can tell any differencebetween donepezil and placebo. The tremendous wall of vendorsponsored randomised controlled trials has created a terriblefalse impression about these drugs, and desperate families seekdesperate remedies.

Thomas E Finucane, professor of medicine

Johns Hopkins University School of Medicine, Burton Pavilion, 5505 Hopkins Bayview Circle, Baltimore, MD 21224, USA

tfinucan@jhmi.edu

Competing interests: None declared.

Gulland A. NICE guidelines create ethical dilemmas in care of elderly people, says report. BMJ 2007;335:791. (20 October.) doi:10.1136/bmj.39371.570509.DB[Free Full Text]
Courtney C, Farrell D, Gray R, Hills R, Lynch L, Sellwood E, et al, AD2000 Collaborative Group. Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial. Lancet 2004;363:2105-15.[CrossRef][Web of Science][Medline]
Howard RJ, Juszczak E, Ballard CG, Bentham P, Brown RG, Bullock R, et al; CALM-AD Trial Group. Donepezil for the treatment of agitation in Alzheimer's disease. N Engl J Med 2007;357:1382-92.[Abstract/Free Full Text]