Many of the symptoms of Huntington's disease (HD) are, at least partially treatable. In this section we provide information on prescription drugs and treatments that are available for depression, anxiety, irritability, obsessive-compulsive behaviors, and chorea symptoms. We provide information on nutritional supplements, but no longer recommend them at present. Whether prescription drugs or over-the-counter supplements supervision by your local doctor is vital.
While drugs are important, the "best medicine" for HD is a healthy lifestyle that includes physical exercise, social and intellectual stimulation, and improved sleep patterns, all of which are beneficial for all persons and especially for those with neurodegenerative diseases. While we encourage you to learn more about about available drug treatments, and seek them out if needed, it is very important to work hard on a more healthy life style.
- Obsessive Compulsive Behavior
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, falling into 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 symptom categories. There are no drug or supplement studies in people that have shown neuroprotection or slowing of HD progression.
Symptom Treatments: This category provides treatment information for chorea 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 drug treatment benefit for any symptom to 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 Xenazine® (tetrabenzazine) has been well studied. For psychiatric symptoms the situation is worse; there are no high qualitiy studies in Huntington's patients demonstrating consistent 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.
Supplements: Though clinical trials are underway for both Coenzyme Q-10 and creatine, there is no proof than any supplement is helpful for HD individuals. If you choose to use a supplement make sure they have been consumer lab tested, and make sure your doctor knows which ones you are taking. Large dosage of various supplements can be harmful and should be taken only in a clinical trial setting.