Donepezil Treatment of Hypersomnia After COVID-19

Abstract

The long-term effects of coronavirus disease-2019 (COVID-19) are not yet fully understood and some are due to central nervous system involvement. COVID-19 was reported to cause fatigue in some people after a long-term viral illness, characterized by daytime wakefulness and disturbed sleep cycles. Herein, a 90-yearold patient is presented, who developed hypersomnia after COVID-19 and showed signs of cortical atrophy in the left chronic thalamic infarction area and bilateral temporal lobe anteromedial parts in cranial magnetic resonance imaging, as well as increased wakefulness with donepezil treatment. Donepezil is an acetylcholinesterase inhibitor that increases the level of acetylcholinesterase that inhibits gamma-aminobutyric acid release in the forebrain via the serotonin system, which increases dopamine levels in the nucleus accumbens. The serotonin system has been noted for its positive effect on excessive sleepiness and Epworth sleepiness scale score improvement.