An Evidence-based Critical Appraisal of a Topic:: Effectiveness of High Dose Donepezil for Advanced Alzheimer's Disease

Cholinesterase inhibitors (ChEIs) have become the main approach to symptomatic treatment in mild to moderate Alzheimer's disease. Unfortunately, there is no evidence that these drugs impact clinical progression. The objective of this article is to determine whether the newly released higher dose of ChEI donepezil (23 mg/d) provides improved therapeutic benefit over the standard dose (10 mg/d). The clinical question is addressed through an evidence-based process that includes developing a clinical scenario, forming a guiding clinical question and search strategy, selecting published evidence, devising an evidence summary, performing a critical appraisal, and analyzing the results.