Goals in symptomatic pharmacologic management of frontotemporal lobar degeneration

ArticleinAmerican Journal of Alzheimer s Disease and Other Dementias 17(5):267-72 · September 2002with9 Reads
Impact Factor: 1.63 · DOI: 10.1177/153331750201700504 · Source: PubMed
Abstract

This review ofpharmacotherapyforfrontotemporal lobar degeneration describes the chemical rationale for agents used and reports observed responses to psychotropic medications. Paroxetine addressed anxiety and repetitive, ritualistic behaviors. Depression was resistant to treatment. Valproic acid and quetiapine calmed agitated subjects without exacerbating Parkinsonism. Donepezil has not emerged as a beneficial medication for this group of subjects. Behavioral disturbances can be alleviatedpharmacologically, but further research might determine guidelines for management of this non-Alzheimer's dementia syndrome that could decrease the frequency of adverse drug events.

    • "Early, accurate diagnosis offers the best prospect for effective management of patients with FTD. Explaining to caregivers that the behavioral features have a certain neurological basis is important [35, 61] . Understanding the anatomical underpinnings of these altered personality characteristics and behaviors can help caregivers accept and adjust to the patients' behavior. "
    [Show abstract] [Hide abstract] ABSTRACT: Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by changes in behavior and language caused by focal degeneration of the frontal and anterior temporal lobes. The behavioral symptoms are distressing to patients and their caregivers. Non-pharmacological management is important as no disease-specific pharmacological treatment for FTD is currently available. The primary objective is to review the literature on non-pharmacological management for FTD and to propose directions for future research, with reference to findings. A search was performed using PubMed, MEDLINE, and EMBASE. Search terms included "frontotemporal dementia", and words related to non-pharmacological management, and it identified a total of 858 articles. Results revealed that very few randomized controlled trials exist on non-pharmacological management interventions for FTD. These interventions have been proposed by literature based on clinical experience. A small number of studies have supported behavioral management techniques that exploit disease-specific behaviors and preserved functions in patients with FTD, along with the management of caregivers' distress. These limitations warrant well-designed large-scale research to examine effects of non-pharmacological interventions on behavioral symptoms of FTD.
    No preview · Article · Mar 2015 · Journal of Alzheimer's disease: JAD
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    • "Cognitively, both pathologies present with executive impairment, although in patients with bvFTD, executive performance tends to be spared in the early stages when cognitive functioning is relatively preserved. Among patients with bvFTD, depression is more strongly associated with severe frontotemporal atrophy , especially within the temporal lobe, while emotional disturbances tend to correlate more strongly with early atrophy of right temporal areas (Bozeat et al., 2000; Chow & Mendez, 2002). It is important to highlight that normal ageing can lead to frontal cortex atrophy (Chow et al., 2008; Raz et al., 1997) and this fi nding may be present in patients diagnosed with late onset depression. "
    [Show abstract] [Hide abstract] ABSTRACT: Abstract Several factors make diagnosis of a possible behavioural variant of frontotemporal dementia (bvFTD) particularly challenging, especially the overlap of certain symptomatic dimensions such as apathy, disinhibition, depression, anhedonia, stereotyped behaviour, and psychosis between bvFTD and several psychiatric disorders that appear in late adulthood. We discuss the most frequent psychiatric conditions that can simulate early bvFTD symptoms, including late onset bipolar disorder, late onset schizophrenia-like psychosis, late onset depression, and attention deficit hyperactivity disorder in middle and older age.
    Full-text · Article · Apr 2013 · International Review of Psychiatry
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    • "Cognitively, both pathologies present with executive impairment, although in patients with bvFTD, executive performance tends to be spared in the early stages when cognitive functioning is relatively preserved. Among patients with bvFTD, depression is more strongly associated with severe frontotemporal atrophy , especially within the temporal lobe, while emotional disturbances tend to correlate more strongly with early atrophy of right temporal areas (Bozeat et al., 2000; Chow & Mendez, 2002). It is important to highlight that normal ageing can lead to frontal cortex atrophy (Chow et al., 2008; Raz et al., 1997) and this fi nding may be present in patients diagnosed with late onset depression. "
    Full-text · Article · Apr 2012 · Neurology
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