The Pharmaceutical Journal
Vol 269 No 7207 p89
20 July 2002

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Donepezil trial raises ethical questions

The results of a trial which suggest that donepezil (Aricept) helps pilots retain skills they have learnt during training have raised questions about cognitive enhancement of healthy people.

The authors of the study comment: "If cognitive enhancement becomes possible in intellectually intact individuals, significant legal, regulatory and ethical questions will emerge." How would such interventions be funded? Would the divide between rich and poor be further widened as the rich are cognitively enhanced with drugs, they ask.

The researchers conducted a trial involving 18 pilots with a mean age of 52 years (range 30–70 years). The pilots undertook seven practice flights in a flight simulator to train them to perform a complex series of air traffic control instructions as well as respond to three randomly occurring emergency situations demanding quick, appropriate reactions. The pilots were then split into two groups; one group took 5mg donepezil daily for 30 days and the other took placebo. All pilots flew a further two flights on day 30.

The researchers found that in the donepezil group flight performance did not change significantly from baseline, whereas performance in the placebo group declined (P<0.05).

The data should not be interpreted to advocate widespread use of donepezil in healthy individuals since side effects might become apparent in larger populations, the researchers warn (Neurology 2002;59:123).