I38 A clinical based synopsis of available psychopharmacological treatment in huntington’s disease

Background The clinical manifestations of Huntington’s disease (HD) also include psychiatric disturbances, as well as motor and cognitive disorders. Estimated rates for lifetime prevalence of psychiatric disorders among HD patients vary between 33% and 76%. Tetrabenazine is considered the first line treatment for motor disturbances in absences of some psychiatric contraindication (suicide risk). The current literature on the psychopharmacological treatment lack of a large randomised controlled trial, however many small case series are available. Aims We present a review of the literature describing treatments of psychiatric manifestation in HD, focusing on specific disturbances and the role of polytherapy. Methods A search in the main database sources (Medline, Isi Web of Knowledge and Medscape) has been performed in order to obtain a comprehensive evaluation of available psychopharmacological treatment in HD. Results Antidepressants like selective serotonin and serotonin norepinephrine reuptake inhibitors improve depression and are also used in obsessive-compulsive symptoms in HD patients. Mood stabiliser (Valproic Acid or Lamotrigine), alone or in combination with other drugs, are used in pathological mood swings and irritability. Atypical antipsychotics (Risperdidone, Olanzapine and Aripiprazole) were used in psychotic symptoms, and for managing agitation also in place of Tetrabenazine, with reduction of pathological movement. Conclusions Psychiatric symptoms in HD seem to respond well to psychopharmacological treatment. It is important to recognise psychiatric aspects and tailoring specific treatment, not only for psychopathology treatment with improvement of mood, ideation and quality of life of patients and prevention of serious complications how suicidality, but even for better managing neurological symptoms in HD.