Huntington's disease is an inherited, degenerative condition that causes destruction of nerve cells in the brain. It is characterized by progressive emotional and cognitive disturbances and an involuntary movement disorder called chorea. While tetrabenazine is the first drug approved by the Food and Drug Administration to treat chorea, other drugs are available to address symptoms related to depression, anxiety, mood swings, obsessions and compulsions.
Tetrabenazine
Tetrabenazine is a drug that was approved by the Food and Drug Administration in 2008 for the treatment of Huntington's disease. By boosting the amount of dopamine in the brain, it may help to alleviate involuntary jerking movements known as chorea that are associated with the disorder, according to the Mayo Clinic. According to a review published in "Cochrane Database of Systematic Reviews" in July 2009, tetrabenazine is the only drug that has been significantly effective in managing symptoms of chorea. The Mayo Clinic advises that the drug can cause drowsiness, insomnia, restlessness and nausea and is not recommended for people who are suffering from depression or who may have suicidal thoughts.
Tranquilizers and Anxiolytics
Tranquilizers and anxiolytics, or anti-anxiety drugs, are sometimes prescribed to treat movement-and anxiety-related symptoms. According to the Mayo Clinic, minor tranquilizers, including benzodiazepines like clonazepam, and major tranquilizers, including antipsychotic medications such as haloperidol, chlorpromazine, olanzapine and clozapine, may provide some relief of symptoms of chorea, severe anxiety, hallucinations, delusions and violent outbursts. Some people may not tolerate these drugs well as they can cause sedation or worsening muscle rigidity. According to the Neurology Channel, antipsychotics should not be taken by patients with dystonia--a state in which involuntary muscle contractions cause an abnormal twisting of part of the body.
Although not a tranquilizer or anxiolytic by class, beta-blockers such as propranolol may also be used to treat symptoms of anxiety, according to the Neurology Channel.
Anti-depressants and Mood Stabilizers
Mood stabilizers, or anti-manic agents, such as lithium, carbamazepine and valproate are sometimes prescribed to Huntington's patients with bipolar disorder or those who exhibit extreme swings in mood or manic episodes--periods of abnormally energetic, expansive, or irritable mood sometimes accompanied by reckless or extreme behavior.
According to the Mayo Clinic, people with Huntingon's may also develop depression, obsessive thoughts and urges to repeat compulsive rituals. To combat these symptoms, antidepressants such as fluoxetine, nortriptyline and sertraline may be prescribed.
Botulinum Toxin
Botulinum toxin injections are sometimes administered to Huntingon's disease patients who have problems with jaw clenching and dystonia, according to the Neurology Channel. Botulinum toxins are proteins produced by the Clostridium botulinum bacterium. According to the University of Florida Movement Disorders Center, these toxins block the release of a neurotransmitter called acetylcholine that is responsible for causing persistent muscle contractions and twisting associated with dystonia. The injections take effect within 3 days to 2 weeks and may provide relief of symptoms for up to a few months at a time. Botulinum toxin injections are approved by the Food and Drug Administration specifically for the treatment of two types of dystonia known as cervical dystonia and blepharospasm.
References
- Mayo Clinic: Huntington's Treatment
- "Cochrane Database of Systematic Reviews;" Therapeutic Interventions for Symptomatic Treatment in Huntington's Disease; Mestre T et al.; July 2009
- University of Florida: Botulinum Toxin
