By Martha Nance, MD, Director, Huntington’s Disease Center of Excellence at Hennepin County Medical Center
There is not yet a cure for Huntington’s disease, but several treatments have been found to reduce the symptoms and improve the quality of life. Today, there are medications to treat chorea, as well as drugs that address psychiatric and behavioral symptoms. Sometimes multiple interventions are used, with the plan of treatment evolving over the course of the disease.
Medications for Movement Disorders
Several drugs are used “off-label” to treat the chorea that people with Huntington’s disease experience, and one drug was approved by the FDA in 2008 specifically for the treatment of chorea.
Drugs that block the effects of dopamine in the brain are commonly used to treat both the movement disorder and behavioral problems. This group of drugs includes older compounds, such as haloperidol, fluphenazine, and chlorpromazine, and newer compounds such as risperidone, olanzapine, and quetiapine. Drugs that reduce anxiety, such as alprazolam or clonazepam, may reduce movements that are made worse by anxiety. Tetrabenazine, a dopamine-depleting drug, is the most recent drug to be used for chorea, and was approved for this use by the FDA after research showed that it reduced chorea by almost 25% in a group of people with Huntington’s disease.
Co-enzyme Q10 and creatine are two vitamin-like substances, both of which support the function of the nerve cells’ furnaces, or mitochondria. Both compounds are being tested to see if they slow or stabilize the course of Huntington’s disease. While still controversial and unproven, these compounds may emerge as a useful Huntington’s disease treatment options.
All drugs have potential side effects as well as potential benefits. The treating physician should always make it clear why a medication is being used, what the possible side effects might be, and what to do if a person experiences side effects. Drugs that block or deplete dopamine have the potential to cause stiffness (rigidity), and to cause or worsen depression, and antianxiety drugs can cause sedation or sleepiness.
Medications for Psychiatric Conditions
A variety of psychiatric and behavioral symptoms can occur in people with Huntington’s disease. The most common of these are depression, anxiety, and irritability. Serotonin reuptake inhibitors, such as sertraline, fluoxetine, or paroxetine, may help these symptoms. Severe mood swings or aggressive behavior can be blunted by using “mood stabilizers” such as valproic acid or gabapentin, or by the addition of antipsychotic drugs such as olanzapine or aripiprazole. Antianxiety medications can help the anxiety that accompanies, and in turn, exacerbates these symptoms. Physicians must monitor these Huntington’s disease treatments carefully to minimize side effects.
In addition to medications, the treatment of Huntington’s disease should incorporate psychotherapy, speech therapy, physical therapy and occupational therapy to help people with Huntington’s disease to optimize their functional abilities.
Because Huntington’s disease affects the entire family, Huntington’s Hope raises post-secondary education scholarship money for the children of parents with Huntington’s disease. The organization hopes to raise $1 million in 2013 with 100 percent of Huntington’s disease donations going directly into an endowment fund to create these scholarships.
To help, please DONATE NOW.
Good Samaritan Society – Specialty Care Community in Robbinsdale, Minn., owned and operated by the Evangelical Lutheran Good Samaritan Society, is one of only eight long-term skilled care centers in the United States with a dedicated program for individuals with Huntington’s disease.