Behavioral Symptoms
Part 6

The Behavioral Changes Associated with Huntington's disease

Are Behavior Changes Treatable?

Currently, there is no way to repair the damage to the brain that leads to the behavioral symptoms of Huntington’s Disease. Behavioral changes are often primarily due to the damage of neurons and neuronal connections in the brain, which at this time are considered irreversible. However, scientists and researchers continue to investigate the brain’s ability to produce new neurons as well as its ability to form new connections between neurons. For more information on the brain’s natural ability to repair itself, click here. Fortunately, there are drugs available for the management of behavioral symptoms, and there are strategies for minimizing the frequency of difficult behaviors.

The maintenance of an individual’s personality is critical to coping with the losses that occur in the context of HD. Such maintenance can ward off depression, frustration and irritability. Treatments for behavioral problems can be as simple as social contact with others and activities outside the home. Given the apathy often associated with HD, however, a caretaker may need to suggest an activity and provide the initiative. Engagement in an activity that the individual has always enjoyed can be especially therapeutic, even if the activity must be modified to some extent. A calm, predictable environment can reduce the frustration and irritability caused by information overload and may therefore help minimize problem behaviors. To read about how the environment can cause or exaggerate behavioral symptoms, click here.

A variety of drugs are available for the treatment of behavioral symptoms. While caffeine can act as an anti-depressant, anti-depressant medication is generally used successfully for the treatment of depression in HD patients. In the rare cases of Obsessive-Compulsive Disorder, Bipolar Disorder, hallucinations or delusions, a psychiatrist can be consulted and may prescribe antipsychotic medication. Apathy, the most common behavioral symptom of HD may be treated with psychostimulants, such as Ritalin. Anxiety is usually treated with Selective Serotonin Reuptake Inhibitors (SSRIs) which increase levels of serotonin, a brain chemical known to regulate mood, emotion, sleep and appetite.

Most medications used to treat the symptoms of HD have side effects. Given the potential for such side effects, it may sometimes be difficult to tell whether a particular symptom such as apathy is a sign of the disease or a reaction to medication. Seeing a physician with knowledge about HD may be important in the treatment of motor, cognitive and behavioral symptoms. For hints on how to find an HD-knowledgeable doctor, click here.

Patients with HD are often underdiagnosed and undertreated for the behavioral aspects of the disease. For some, the behavioral symptoms can be the most distressing aspect of HD. Fortunately, scientists researching new treatments for HD recognize the importance of treating behavioral symptoms as well as movement symptoms and continue to explore new ways to effectively treat behavioral symptoms.

Overall, treatments for HD can be divided into two categories: treatments that improve symptoms, and treatments that slow down the progression of the disease. Currently, there are no treatments available that slow down the progression of HD. However, as research continues, there are growing hopes that science will discover the means by which to not only treat, but also cure HD. For more information on potential treatments for HD, click here.

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-K.Hammond 1-01-03

For further reading:

1. Crauford, D., Thompson, J., & Snowden, J. “Behavioral Changes in Huntington’s Disease”. Neuropsychiatry, Neuropsychology, and Behavioral Neurology. Vol. 14, No. 4, p. 219-226. Philadelphia: Lippincott Williams & Wilkins, Inc., 2001.
   The largest and most comprehensive study on the behavioral symptoms of HD. This published article contains information on the procedure, results and analysis of the data obtained in this study.
2. Huntington Study Group. Huntington’s Disease Overview. http://www.huntington-study-group.org/HUNTINGTON%27S%20DISEASE%20OVERVIEW.html
   A fairly basic overview of HD and its three main aspects: the movement disorder, the cognitive disorder and the psychiatric disorder.
3. Huntington’s Disease Association. Fact Sheet 10. Behavioral Problems in Huntington’s Disease. http://www.hda.org.uk/charity/download.html
   This clearly-written Fact Sheet is just one of the many informative and helpful Fact Sheets available at this site.
4. Kansas University Medical Center. Department of Neurology. Behavioral Problems in Huntington’s Disease. http://www.kumc.edu/hospital/huntingtons/behavior.html
   A helpful guide for coping with and caring for individuals experiencing the behavioral symptoms of HD.
5. Paulsen, J. “Understanding Behavior in Huntington’s Disease” (2nd ed.). Huntington’s Disease Society of America, Inc, 1999.
   This is an easy to read and extremely informative resource with the purpose of providing practical and helpful information about the behavioral symptoms of HD.
6. Rosenblatt, A., Ranen, G., Nance, M. & Paulsen, J. “A Physician’s Guide to the Management of Huntington’s Disease” (2nd ed.). Huntington’s Disease Society of America, Inc., 1999.
   This is a guide specifically for physicians. It explains the symptoms of Huntington’s Disease and methods for providing optimal management of the symptoms.

Last Modified: 1-01-03

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