Antipsychotic drugs in Huntington’s disease

ABSTRACT

Introduction: The aim of this review is to overview the pharmacological features of neuroleptics experienced in the treatment of Huntington’s disease (HD) symptoms. Despite a large number of case reports, randomized controlled trials (RCT) and drug comparison studies are lacking.

Areas covered: After evaluating current guidelines and clinical unmet needs we searched PubMed for the term ‘Huntington’s disease’ cross referenced with the terms ‘Antipsychotic drugs’ ‘Neuroleptic drugs’ and single drug specific names.

Expert commentary: In clinical practice antipsychotics represent the first choice in the management of chorea in the presence of psychiatric symptoms, when poor compliance is suspected or when there is an increased risk of adverse events due to tetrabenazine. Antipsychotics are considered valid strategies, with the second generation preferred to reduce extrapyramidal adverse events, however they may cause more metabolic side effects. In the future ‘dopamine stabilizers’, such as pridopidine, could replace antipsychotics modulating dopamine transmission.

KEYWORDS:

• Huntington’s disease
• antipsychotic drugs
• extrapiramidal side effects
• aggressiveness
• involuntary movements

Declaration of interest

U Bonucelli has received research funding from Lundbeck and Chiesi Pharma Italy, and has received honoraria from Zambon and UCB Pharma Italy. R Ceravolo has received fees for speech from Zambon, UCB Pharma and General Electric. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.