Psych CASC / OSCE · Psychopharmacology — cognitive enhancers
Explaining donepezil and expectations to a carer (CASC)
CASC-style communication station: realistic benefit counselling, AD2000 appraisal without nihilism, memantine timing, GI management, and shared monitoring plan.
On this page
Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Daughter of a 76-year-old man newly diagnosed with mild Alzheimer disease wants 'the tablet that stops dementia'. She has read that donepezil is 'useless' (AD2000 headlines) and also asks whether to start memantine and donepezil together today. Father has mild nausea on a trial of donepezil 5 mg started by the GP.
Station instructions (candidate)
You have 7 minutes with the daughter. Explain what donepezil can realistically achieve, address the AD2000 “useless drug” narrative without dismissing her reading, manage mild nausea, explain why dual memantine start is not automatic in mild disease, and agree a monitoring plan including when combination or stopping might be discussed later. Do not guarantee cure. Do not force treatment. Use plain language and check understanding.[1][2][5]
References6ShowHide
- [1]Rogers SL, Farlow MR, Doody RS, et al. A 24-week, double-blind, placebo-controlled trial of donepezil in patients with Alzheimer's disease Neurology, 1998.PMID 9443470
- [2]Courtney C, Farrell D, Gray R, et al. Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial Lancet, 2004.PMID 15220031
- [3]Howard R, McShane R, Lindesay J, et al. Donepezil and memantine for moderate-to-severe Alzheimer's disease N Engl J Med, 2012.PMID 22397651
- [4]Tariot PN, Farlow MR, Grossberg GT, et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial JAMA, 2004.PMID 14734594
- [5]Birks JS, Harvey RJ Donepezil for dementia due to Alzheimer's disease Cochrane Database Syst Rev, 2018.PMID 29923184
- [6]Reisberg B, Doody R, Stöffler A, et al. Memantine in moderate-to-severe Alzheimer's disease N Engl J Med, 2003.PMID 12672860