What is the role of medications in the treatment of frontotemporal lobe dementia with motor neuron disease (FTD/MND)?

Updated: Apr 11, 2017
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

Answer

No specific treatment is available for frontotemporal lobe dementia with motor neuron disease (FTD/MND). Treatments for MND, such as riluzole, do not appear to affect the course of the dementia-inducing illness. Riluzole is currently the only licensed medication for MND. Available data from therapeutic trials in MND do not show beneficial cognitive effects, although there are no specific contraindications in this context.

Gabapentin has been studied in trials as a disease-modifying agent in patients with MND but does not demonstrate specific cognitive-enhancing properties.

Acetylcholinesterase inhibitors (eg, donepezil, rivastigmine) are used to correct the cholinergic effect associated with Alzheimer disease. Although not studied specifically in FTD, anecdotal reports suggest they may increase irritability in patients with FTD.

Patients with FTD who have profound presynaptic serotonergic deficits and behavioral disturbances may respond to selective serotonin reuptake inhibitors.

Optimal symptomatic dopaminergic therapy should be offered to patients with overlap syndromes with idiopathic Parkinson disease and MND. On the other hand, selective dopamine blockers, such as olanzapine, may be useful in agitated patients; monitor for adverse effects, such as extrapyramidal syndromes.


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