Introduction: a professional man sustained a residual, persisting, isolated impairment of short-term memory secondary to severe carbon monoxide poisoning. Informal, open trial of the cholinesterase inhibitor donepezil resulted in uncertain benefit.
Protocol: an N-of-1 randomized, double-blind controlled trial of donepezil against placebo. Placebo-induced headache permitted evaluation of donepezil at only the 5 mg dose.
Results: there was no improvement in short-term memory.
Conclusion: the trial excluded significant benefit of donepezil 5 mg in this patient, preventing long-term unnecessary prescription. Beneficial effects in other similar patients or at higher dosage cannot be excluded.