Frontotemporal Dementia

This article delves into Frontotemporal Dementia (FTD), a neurodegenerative disorder affecting the frontal and/or temporal lobes of the brain. It outlines the behavioral changes associated with FTD, discusses the lack of approved disease-modifying treatments, and reviews both pharmacological and non-pharmacological management strategies. The article emphasizes the importance of behavioral modification and structured environments, as well as pharmacologic treatments, including cholinesterase inhibitors and serotonin reuptake inhibitors.

Characteristics of Frontotemporal Dementia

Frontotemporal dementia (FTD) is a neurodegenerative disorder affecting the frontal and/or temporal lobes. It is characterised by behavioral changes and it might be associated with parkinsonism, corticobasal syndrome and/or progressive supranuclear palsy. FTD is one of the common causes of early-onset dementia, and the average age of onset is the sixth decade. Behavioral changes in FTD include Hyperorality, disinhibition, inertia, agitation, compulsions, and/or apathy.

Non-Pharmacological Management of FTD

There is no current approved disease modifying treatment (DMT) for FTD. Symptomatic medications should be considered in conjunction with non-pharmacological intervention. For behavioural disorders, patients often require protection from serious consequences of impaired judgment and driving. Also, a well-structured environment which avoids overstimulation and distraction can provide stability for the patient. Regular exercise programs and physical therapy should be encouraged for patients with dementia. Behavioural modification techniques, such as, monitoring log may help identify triggers that should be avoided.

Pharmacologic Treatment in FTD

Pharmacologic treatment in FTD includes cholinesterase inhibitors and behavioural therapy modification. Patients frequently have serotonergic and dopaminergic dysfunctions.

Management of Behavioural Symptoms in FTD

For behavioural symptoms, a trial of a serotonin reuptake inhibitor, such as, citalopram or trazodone could be beneficial. Also, other SSRIs including sertraline, paroxetine showed some benefits as per trial results. Additionally, atypical antipsychotic medications can help with agitation and other neurobehavioral symptoms in the course of the disease.

References

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