Clozapine treatment for Huntington’s disease psychosis

Bampton, Tristan J; Hack, Daniel; Galletly, Cherrie

doi:10.1177/00048674211013082

Cited by 4 publications

(1 citation statement)

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“…Quetiapine showed positive results in case reports and a series comprised of 5 patients, 97 , 223 , 224 whereas clozapine was found to be effective in two middle-aged adults with treatment-refractory HD psychosis. 225 , 226 The International Guidelines for the Treatment of Huntington’s Disease suggest clozapine as first line for psychosis in patients with akinetic HD and disabling parkinsonian symptoms. 220 HD psychosis can be severe and relentless; in some cases, combinations of two antipsychotics are necessary, although this should be avoided as much as possible due to risk of tardive dyskinesia and worsening parkinsonism, which often emerges later in the course of the disease.…”

Section: Resultsmentioning

confidence: 99%

Advances in the Diagnosis and Management of Psychotic Symptoms in Neurodegenerative Diseases: A Narrative Review

Seritan

2023

J Geriatr Psychiatry Neurol

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Background: Approximately 15% of older adults may experience psychotic phenomena. Primary psychiatric disorders that manifest with psychosis (delusions, hallucinations, and disorganized thought or behavior) account for less than half. Up to 60% of late-life psychotic symptoms are due to systemic medical or neurological conditions, particularly neurodegenerative diseases. A thorough medical workup including laboratory tests, additional procedures if indicated, and neuroimaging studies is recommended. This narrative review summarizes current evidence regarding the epidemiology and phenomenology of psychotic symptoms encountered as part of the neurodegenerative disease continuum (including prodromal and manifest stages). Results: Prodromes are constellations of symptoms that precede the onset of overt neurodegenerative syndromes. Prodromal psychotic features, particularly delusions, have been associated with an increased likelihood of receiving a neurodegenerative disease diagnosis within several years. Prompt prodrome recognition is crucial for early intervention. The management of psychosis associated with neurodegenerative diseases includes behavioral and somatic strategies, although evidence is scarce and mostly limited to case reports, case series, or expert consensus guidelines, with few randomized controlled trials. Conclusion: The complexity of psychotic manifestations warrants management by interprofessional teams that provide coordinated, integrated care.

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