Managing Huntington's disease

Treatment for Huntington's

Currently there is no cure for Huntington's disease and the goal of treatment is to increase the patient’s quality of life. In order to do this medical professionals target 4 main areas;

• ·         Reducing the severity of motor dysfunction
• ·         Reducing psychological disorders
• ·         Weight loss and malnutrition
• ·         Tackling depression and the emotional affects of the disease.

Motor dysfunction

Several drugs can be used to try and manage the movement problems associated with Huntington's disease.

Chorea can be treated using tetrabenazine a drug used in the US, Australia and New Zealand.

Neuroleptics also help manage motor problems and are also antipsychotics so useful in treating some of the psychological symptoms of Huntington's disease.

Benzodiazepines which act as an anticonvulsant prevent muscle spasms.

Anti-Parkinson’s drugs, for example amantadine,  are also used. By increasing the level of dopamine in the brain they treat hypokinesis and muscle rigidity problems associated with Huntington's disease.

Psychological disorders

Treatments for psychological symptoms are the same as those used to treat other psychological disorders for example

• Selective serotonin reuptake inhibitors SSRIs – treat depression, anxiety and personality disorders
• Dopamine blockers –are used as antipsychotics and antidepressants e.g. clozapine and risperidone
• Other antipsychotics – e.g. haloperidol

Weight loss and malnutrition

Weight loss and malnutrition are very common symptoms due to patients having problems with muscle movement and dysphagia. These symptoms can be managed by keeping a close eye on the patients nutritional intake and if neccessary thickening agents can be used to prevent chocking and to increase the ease of swallowing.

If weight loss becomes very severe and the patient can’t increase their food intake a food tube may be inserted in order to make sure they receive all the nutrients they need.

Depression

Of the biggest causes of death for Huntington's patients is suicide. Because of this patients moods and emotions should be closely mointored in order to manage the emotional strain caused by the disease and any depression. As well as using the anti-depressants highlighted above, there is also support groups and counselling available for patients finding it hard to come to terms with their illness.

Prognosis

Most deaths in Huntington's patients are caused by infection and pneumonia, this is followed secondly by heart disease and then by suicide with over 25% of Huntington's patients attempting to take their own lives. The onset and speed of progression of symptoms is very dependent on the number of CAG repeats. Patients with a high number of trinucleotide repeats (over 60) will often have an onset of symptoms at a young age where as patients with 40 repeats or less may often have no or very little symptoms. Patients with Huntington's disease get progressively worse over time and normally have an outlook of approx 15-20 years after onset.