Objectives：Recent studies in autistic brain samples have shown diminished acetylcholine and nicotinic receptor activity. We hypothesized that acetylcholinergic enhancement may pharmacologically improve some autistic characteristics. Donepezil hydrochloride, a cholinesterase inhibitor, was studied in few studies which showed improvement in the expressive and receptive speech of autistic children. We therefore undertook an open label trial to evaluate this effect on speech function in Korean autistic children. Methods：Twenty-one patients (18 males, 3 females, average age 77.9±23.7 months), with a diagnosis of autism spectrum disorder enrolled in a 12-week open label trial of donepezil hydrochloride. Changes were evaluated by PLS (Preschool language scale). Testing was administered at baseline and at 12-week follow-up. Results：Test administered at baseline and at 12-week follow-up showed gains in both expressive and receptive speech functions. Conclusion：Donepezil hydrochloride, a cholinesterase inhibitor, appears to improve expressive and receptive speech functions of autistic children
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