Medical Treatment

Even though Pick disease is not reversible, treatment can slow the progression of symptoms in some people. Relieving symptoms can improve function significantly. Some of the important treatment strategies in dementia are described here.

Nondrug treatment

Behavior disorders such as agitation and aggression may improve with various interventions. Some interventions focus on helping the individual adjust or control his or her behavior. Others focus on helping caregivers and other family members change the person’s behavior. These approaches sometimes work better when combined with drug treatment.

Drug treatment

The symptoms of Pick disease can sometimes be relieved, at least temporarily, by medication. Many different types of medications have been or are being tried in dementia. One group of drugs used in Alzheimer disease, the cholinesterase inhibitors, has been tried in Pick disease.

• These drugs increase the levels of acetylcholine, a brain hormone related to memory and attention.
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• These drugs are not a cure. They improve speech and language in some people with the disease. In other people, they have no effect.
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• Many people with Pick disease cannot take one of these drugs, donepezil (Aricept), because the drug can worsen symptoms such as agitation and aggression.

Other drugs are being used in people with Pick disease. On the basis of what we know from research about the disease, these drugs may help.

• The antioxidant tocopherol (vitamin E) may counteract the damage in brain cells that causes Pick disease and slow the worsening of the disease.
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• Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are used in many people with the disease to increase levels of a brain hormone called serotonin. This hormone may improve thinking.

Other, more experimental, treatments are being used by some specialists who treat Pick disease. These treatments are not widely accepted as helpful in the disease.

• Anti-inflammatory drugs are being tried on the premise that inflammation is one cause of the brain damage in Pick disease.
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• Hormone replacement therapy has been given to some women who have been through menopause and have dementia, but this approach has been questioned by many experts. The rationale is that the loss of estrogen at menopause takes away one line of protection from the disease.

Certain drugs are used to treat specific symptoms or behavior changes.

• Mood swings and emotional outbursts may improve with antidepressant or mood-stabilizing drugs.
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• Agitation, anger, and disruptive or psychotic behavior are often relieved by antipsychotic medication or mood stabilizers.