Symptomatic sinus bradycardia associated with donepezil

Introduction. Donepezil is a drug which is being used more and more winery in mild-moder ate Alzheimer's disease. In general, it is well tolerated and the side-effects are basically cholinergic-dependent. Symptomatic disorders of cardiac rhythm associated with the use of donepezil are extremely unusual. Clinical case. We describe the case of an 81 year old patient with hypertensive cardiopathy, who developed sinus bradycardia, fainting and left cardiac failure three weeks after starting treatment with donepezil. When donepezil was stopped the sinus bradycardia disappeared a 24 hour electrocardiographic holter showed no signs of sinus none disease and no episodes of this type occurred during the following six months. Conclusion. Symptomatic sinus bradycardia is a possible adverse effect of treatment with donepezil in Alzheimer's disease.