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Treatments and drugs
By Mayo Clinic staffNo satisfactory treatment is available to stop or reverse Huntington's disease. Some approaches can control signs and symptoms, but Huntington's disease eventually causes physical and mental disability. As the disease progresses, long-term nursing home care may be necessary.
Medications
Tetrabenazine (Xenazine) is the first medication to be specifically approved by the Food and Drug Administration for the treatment of the signs or symptoms of Huntington's. It helps reduce the jerky, involuntary movements of Huntington's disease by increasing the amount of dopamine available in the brain. Possible side effects include insomnia, drowsiness, nausea and restlessness. This medication isn't recommended for use in anyone with depression, especially anyone with suicidal thoughts.
Tranquilizers such as clonazepam (Klonopin) and antipsychotic drugs such as haloperidol and clozapine (Clozaril) can help control movements, violent outbursts and hallucinations. While these medications can be helpful, a common side effect is sedation, and in some cases, these medications may cause additional stiffness and rigidity.
Various medications, including fluoxetine (Prozac, Sarafem), sertraline (Zoloft) and nortriptyline (Pamelor), can help control depression and the obsessive-compulsive rituals that some people with Huntington's disease develop. Medications such as lithium (Eskalith, Lithobid) can help control extreme emotions and mood swings.
Side effects from many of the drugs used to treat the symptoms of Huntington's disease may include hyperexcitability, fatigue and restlessness.
Speech therapy
Huntington's disease can impair your speech, affecting your ability to express complex thoughts. You may find that speech therapy helps. Remind friends, family members and caregivers that if you don't speak, it doesn't necessarily mean that you don't understand what's going on. Ask people to continue talking to you and keep your environment as normal as possible.
Physical and occupational therapy
Physical therapy can help keep muscles stronger and more flexible, which helps maintain balance and may lessen the risk of falling. Occupational therapy can help make your home safer and give you strategies for coping with memory and concentration problems. Later in the disease, occupational therapy can assist you with eating, dressing and hygiene challenges.
Experimental treatments and new research
Scientists are working to try to come up with new treatments to slow the course of Huntington's disease. One area of research is the combination of certain cancer and AIDS drugs. This combination has halted the progress of Huntington's in fruit flies.
The use of stem cells is another avenue for research. Transplanted in the brain, stem cells might help reduce some of the damage that's been done to the neurons in the brain. Animal studies have shown promising results, but much more research must occur.
In October 2008, researchers began recruiting for a randomized, placebo-controlled clinical trial of a new drug currently known as ACR16. This medication stabilizes levels of dopamine, which may improve motor, cognitive and psychiatric functioning.
- Huntington's disease: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/huntington/detail_huntington.htm. Accessed March 27, 2009.
- Huntington's disease. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec16/ch221/ch221e.html#sec16-ch221-ch221e-49. Accessed March 27, 2009.
- SuttonBrown MA, et al. Huntington disease: Clinical features and diagnosis. http://uptodate.com/home/index.html. Accessed March 12, 2009.
- Learning about Huntington's disease. National Human Genome Research Institute. http://www.genome.gov/page.cfm?pageID=10001215. Accessed March 27, 2009.
- Trushina E, et al. Mutant huntingtin inhibits clathrin-independent endocytosis and causes accumulation of cholesterol in vitro and in vivo. Human Molecular Genetics. 2006;15:3578.
- Katsuno M, et al. Getting a handle on Huntington's disease: The case for cholesterol. Nature Medicine. 2009;15:253.
- FDA approves first drug for treatment of chorea in Huntington's disease. U.S. Food and Drug Administration. http://www.fda.gov/bbs/topics/NEWS/2008/NEW01874.html. Accessed March 28, 2009.
- Kim SU. Stem cell-based cell therapy in neurological diseases: A review. Journal of Neuroscience Research. In press. Accessed March 28, 2009.
- ACR16. Neurosearch.com. http://www.neurosearch.com/Default.aspx?ID=752. Accessed March 28, 2009.
