|Treatment Overview||| Print ||
Why encouragement? Huntington's people are often under-treated, especially outside of specialty centers. There are several reasons for this. Huntington's patients don't visit their doctors frequently because of the belief that there are no treatments. The "why bother" attitude. Another reason is that many physicians are not familiar with available treatments when patients come; or even worse they believe that Huntington's is untreatable.
The goal is to provide information that may be helpful to you and your doctor and to encourage you to seek treatments that can improve the quality of your life. We will give dosage information on medications, not to suggest specific dosage for any individual, but to acquaint you with the range of prescribing that is used. All of the treatments listed at HDDW require direction and close supervision by your own doctor.
Treatment Categories: Treatments are separated into two categories: those that are used for symptoms and those that (based on mouse models) may be useful for neuroprotection or slowing of HD progression. Data on neuroprotection is sparse, and often contradictory; with some investigators reporting benefit, while others report lack of benefit for the same tested drug or supplement. We can probably have more confidence in a supplement or life style category if it has shown benefit in different mouse models and different laboratories.
Symptom Treatments: This category provides treatment information for movement symptoms (chorea and rigidity) and for a variety of psychiatric symptoms that are related to mood (like depression), and behavior disturbance (like irritability). This information can be less confusing if you remember three points. First, the same medication can treat many different symptoms. For instance SSRI antidepressants are the first drugs of choice to treat several psychiatric symptoms including depression, anxiety, irritability and obsessive-compulsive behaviors. Second, the treatment of a specific symptom may require drug combinations. Next, do not expect that drug treatment of any symptom will be 100%.
Another important fact to remember is that the scientific evidence-base for any treatment in Huntington's is surprisingly slim. For movement symptoms, only tetrabenzazine has been well studied. For psychiatric symptoms the situation is worse; there are no large studies in Huntington's patients demonstrating efficacy of any single drug, and no large studies comparing the benefit of one drug to another. This means that doctors prescribe drugs for HD symptoms based on their own experience and on results from studies in other diseases.
Neuroprotective Treatments: This category provides information on treatments, both prescription drugs and supplements that may be neuroprotective (based on mice models). Though clinical trials are underway for both Coenzyme Q-10 and creatine, there is no proof than any supplement is helpful for HD individuals.
It must be understood that there is no certainty of benefit for any of the treatments covered here; and that what works in a mouse may not translate to benefit in people. I urge you to weigh the evidence and make your own decision. But be safe: use supplements that have been consumer lab tested, make sure your doctor knows which ones you are taking. Large dosage of various supplements can be harmful. Large doses should be taken only in a clinical trial setting.
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