To investigate the impact of donepezil on emotional responses, cognitive function, and inflammatory factors in patients with Hashimoto's thyroiditis (HT).

A total of 109 patients with Hashimoto's thyroiditis treated in the Department of Endocrinology at Huangshan Shoukang Hospital between February 2021 and May 2024 were selected for this study. The patients were randomly divided into a treatment group (n = 54) and a control group (n = 55) using a random number table. The treatment group was administered donepezil hydrochloride tablets and vitamin C tablets orally in the morning on an empty stomach, while the control group received only vitamin C tablets under the same conditions. Both groups followed this regimen for three months. Outcomes were assessed using the Mini-Mental State Examination (MMSE), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), thyroid hormone levels, and inflammatory markers.

There were no statistically significant differences in thyroid hormone levels (T3, T4, TSH) or thyroid antibodies (TGAb, TPOAb) between the two groups before or after treatment (P > 0.05). Prior to treatment, MMSE, SAS, and SDS scores were comparable between the groups (P > 0.05). After treatment, MMSE scores in the treatment group were significantly higher, while SAS and SDS scores were significantly lower compared to the control group (P < 0.05). Additionally, no baseline differences in inflammatory factors were observed (P > 0.05), but after treatment, serum levels of IL-6, IL-4, IL-1β, and TNF-α were significantly lower in the treatment group compared to the control group (P < 0.05).

Donepezil can improve cognitive function and emotional responses in patients with Hashimoto's thyroiditis, which may be related to the downregulation of key inflammatory factors.