The Neuropsychology of Cortical Dementias (Contemporary Neuropsychology)

Author:, [,]
Language: eng
Publisher: Springer Publishing Company
Published: 2014-12-15T08:00:00+00:00

Medical

Only a handful of studies of pharmacological treatments for bvFTD have been published—very few of them blinded, placebo-controlled trials—and results have been inconsistent. As noted earlier, some studies suggest that bvFTD patients may have dysfunctional metabolism of serotonin. This possibility has led to the use of SSRI medications, but the evidence for this practice is largely based on a single meta-analysis that included several non-placebo-controlled studies (Rabinovici & Miller, 2010). Nonetheless, selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs) are currently the “first-line” pharmacotherapy for bvFTD. Evidence from a randomized placebo-controlled trial indicates that trazodone may also be helpful in treating behavioral problems associated with bvFTD, but the rate of undesirable side effects, such as drowsiness, makes this a less attractive option (Rabinovici & Miller, 2010).

Other drugs sometimes used (with variable efficacy) to target bvFTD symptoms are atypical antipsychotics and AChEIs (Huey et al., 2006; Piguet et al., 2011). However, extreme caution must be taken when considering the use of atypical antipsychotics as these drugs are associated with increased risk of death in elderly patients with dementia (Rabinovici & Miller, 2010). Also, because the cholinergic system may function more normally in contrast to that of AD patients, AChEIs may not show significant efficacy as desired. Efforts are underway to create drugs to target the underlying pathologies of bvFTD (Jicha & Nelson, 2011; Piguet et al., 2011); hopefully this line of research will yield more effective pharmacotherapies.

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