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May 18, 2013
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Huntington Disease Dementia (cont.)

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Medications

Drugs are used to control emotional and behavioral symptoms in persons with HD.

Antidepressants

These drugs help relieve symptoms such as sadness, withdrawal, apathy, sleep problems, and suicidal thoughts.

  • There is a wide range of antidepressant drugs. The choice of antidepressant is usually based on side effects. The goal is to choose the drug that has the fewest side effects for a specific person.

  • Antidepressant drugs may relieve psychotic symptoms, such as agitation and aggression, if they are fairly mild.

  • In some cases, successful treatment of depression can at least partly relieve cognitive problems.

  • The best choices of antidepressants for many people with HD are the selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft).

  • Drugs from another class of antidepressants called the tricyclics are sometimes used. Examples include nortriptyline (Pamelor) and desipramine (Norpramin).

Antipsychotics

These drugs help relieve symptoms such as agitation, screaming, combativeness, or violence. They also relieve symptoms such as paranoia, delusions, and hallucinations.

  • There is a wide choice of antipsychotic drugs. The drug is usually chosen on the basis of side effects and what will be easiest for the person to tolerate.

  • In some people, these drugs can worsen muscle rigidity and stiffness, which worsen the movement problems in HD.

  • They also cause excessive sleepiness in some people.

  • These drugs are given at the lowest doses possible to avoid these side effects.

  • Examples include haloperidol (Haldol), thioridazine (Mellaril), risperidone (Risperdal), and clozapine (Clozaril).

Benzodiazepines

These drugs are most often used to rapidly calm a person who is extremely agitated and/or anxious. These drugs are not widely used in people with dementia because they can actually increase memory problems and confusion. An example is lorazepam (Ativan).

Anticonvulsants

These drugs are used mainly to stop seizures. They tend to stabilize mood and are sometimes used in people who are not psychotic but are agitated or having mood swings. They can also be used for persons with psychotic symptoms that do not get better with antipsychotic treatment. An example is carbamazepine (Tegretol).

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Read What Your Physician is Reading on Medscape

Huntington Disease Dementia »

Huntington disease (HD) is a genetic, autosomal dominant, neurodegenerative disorder characterized clinically by disorders of movement, progressive dementia, and psychiatric and/or behavioral disturbance.

Read More on Medscape Reference »


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