Devanand DP, et al. - Researchers compared add-on donepezil vs placebo as treatment strategies for depressed patients with cognitive impairment receiving stable antidepressant treatment, with a focus on the efficacy and safety of these treatments. Participants were older adults with depression and cognitive impairment; these subjects received 16-week open label antidepressant treatment followed by random assignment to add-on donepezil 5-10 mg daily or placebo for another 62 weeks. In terms of dementia conversion rates, ADAS-Cog, Selective Reminding Test (SRT) Total Immediate Recall, or FAQ, no treatment group differences were seen between donepezil and placebo. Donepezil vs placebo carried more adverse effects. Based on the findings, adjunctive off-label cholinesterase inhibitor treatment in patients with depression and cognitive impairment was not supported.