In your clinical practice, do you find that patients with moderate dementia due to Alzheimer's see much benefit from increasing donepezil dosing from 10 mg/day to a higher dose such as 23 mg/day?

Personally, I do not see much benefit in increasing to 23 mg. To be fair, I do not do this very often, as our cognitive neurologists that I trained with during fellowship rarely did this, given their experience that 23 mg did not offer noticeably more benefit and often many more side effects. I have...

I am very reluctant to increase the dose of donepezil to higher than 10 mg daily. The study in 2010 by Eisai that led to the FDA approval of the 23 mg showed marginal benefits and significantly higher side effects (particularly GI) than the 10 mg standard tablet. I have also seen the 10 mg tab presc...