Donepezil — MRCPsych Paper B MCQ

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EasyOld Age PsychiatryDonepezilMRCPsych Paper B

Which medication is an acetylcholinesterase inhibitor licensed for the symptomatic treatment of mild to moderately severe Alzheimer's dementia and is initiated orally at 5 mg once daily, with the option to increase to 10 mg once daily after at least one month?

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Correct answer: B — Donepezil tablet

Donepezil is the acetylcholinesterase inhibitor with the specified oral regimen: treatment starts at 5 mg once daily, which is maintained for at least one month before a possible increase to 10 mg once daily. NICE includes donepezil, galantamine and rivastigmine as options for mild to moderate Alzheimer's disease, so the dose information is needed to identify a unique answer. Galantamine prolonged-release is also once daily but starts at 8 mg daily. Rivastigmine patches provide daily treatment but start at 4.6 mg/24 hours. Memantine is an NMDA-receptor antagonist rather than an acetylcholinesterase inhibitor. Risperidone is an antipsychotic and is not a treatment for the core cognitive symptoms of Alzheimer's disease.

Reference: Electronic Medicines Compendium. Donepezil 10 mg Orodispersible Tablets, Summary of Product Characteristics, sections 4.1–4.2; text revised 21 November 2025. https://www.medicines.org.uk/emc/product/102454/smpc