The beneficial effect of donepezil on visual hallucinations in three patients with Parkinson's disease

J Geriatr Psychiatry Neurol. 2003 Sep;16(3):184-8. doi: 10.1177/0891988703256054.


Visual hallucinations (VHs) are common psychiatric symptoms in patients with long-standing Parkinson's disease (PD). Treatment with neuroleptics or withdrawal of anti-PD drugs may improve VHs but will worsen motor dysfunctions. The authors report on 3 patients with long-standing PD who were treated with the cholinesterase inhibitor donepezil for the treatment of VHs. Each received a daily dose of 5 mg of donepezil, after reducing or discontinuing anti-PD medications had failed to relieve the VHs. In 2 patients (patient 1, 2), donepezil decreased VHs without worsening motor dysfunctions. In addition, the cognitive status of patient 2 improved. In patient 3, donepezil also resolved VHs, but delusions developed during treatment. After discontinuing donepezil, delusions disappeared and VHs reappeared. Donepezil may ameliorate visual hallucinations in PD patients, but controlled, double-blind trials are necessary to further clarify the effect of this drug on VHs in PD.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholinesterase Inhibitors / therapeutic use*
  • Cognition Disorders / diagnosis
  • Donepezil
  • Female
  • Hallucinations / drug therapy*
  • Hallucinations / etiology*
  • Humans
  • Indans / therapeutic use*
  • Male
  • Middle Aged
  • Parkinson Disease / complications*
  • Piperidines / therapeutic use*
  • Psychomotor Disorders / diagnosis
  • Severity of Illness Index


  • Cholinesterase Inhibitors
  • Indans
  • Piperidines
  • Donepezil