Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management
Introduction Huntington’s Disease (HD) is an autosomal dominant, neurodegenerative condition with a prevalence of 10.6-13.7 per 100,000, caused by the trinucleotide CAG (cytosine, adenine, guanine) repeat expansion in the HTT gene. HD is characterized by a range of motor, cognitive, and psychiatric...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-06-01
|
| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822012081/type/journal_article |
| _version_ | 1797616352313212928 |
|---|---|
| author | J. Jay V. Kumar P. Bidkhanian E. Garrels Y. Segal B. Susaimanickam |
| author_facet | J. Jay V. Kumar P. Bidkhanian E. Garrels Y. Segal B. Susaimanickam |
| author_sort | J. Jay |
| collection | DOAJ |
| description |
Introduction
Huntington’s Disease (HD) is an autosomal dominant, neurodegenerative condition with a prevalence of 10.6-13.7 per 100,000, caused by the trinucleotide CAG (cytosine, adenine, guanine) repeat expansion in the HTT gene. HD is characterized by a range of motor, cognitive, and psychiatric symptoms, the latter of which usually manifest prior to the onset of motor or cognitive disturbances. Amongst psychiatric symptoms, changes in personality are most common, followed by depression. Psychosis has a higher prevalence in those with early-onset
HD.
Objectives
This case report aims to demonstrate an apporach to the management of neuropsychiatric disturbances in HD as well as expose the need for development of an evidence-based apprach to treatment.
Methods
PubMed was searched for the criteria Huntington’s Disease AND Psychosis, with a secondary search for Management of Psychosis in Huntington’s Disease.
Results
The patient is a 54-year-old male with no psychiatric history and reported past medical history of Huntington’s Disease, diagnosed one month ago. He was brought to the Psychiatric ED due to agitation and disorganized behavior at home. On admission, he demonstrated disorganized behavior, grandiose delusions, neurocognitive deficits, and reported auditory hallucinations. With the initiation of tetrabenazine and risperidone his psychiatric symptoms improved and he was able to be discharged to a long-term care facility.
Conclusions
Literature is scarce regarding treatment of psychiatric manifestations of HD. We catered our approach towards safe and effective symptoms management in a multidisciplinary manner. Further research is required to reach an evidence-based consensus as well as develop specific guidelines for managing psychiatric conditions related to HD.
Disclosure
No significant relationships.
|
| first_indexed | 2024-03-11T07:38:47Z |
| format | Article |
| id | doaj.art-1dad714dd1294fd8b5174a391f21a0f6 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:38:47Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-1dad714dd1294fd8b5174a391f21a0f62023-11-17T05:08:50ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S475S47610.1192/j.eurpsy.2022.1208Neuropsychiatric Disturbance in Huntington’s Disease: Approach to ManagementJ. Jay0V. Kumar1P. Bidkhanian2E. Garrels3Y. Segal4B. Susaimanickam5BronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of AmericaBronxCare Health System, Psychiatry, Bronx, United States of America Introduction Huntington’s Disease (HD) is an autosomal dominant, neurodegenerative condition with a prevalence of 10.6-13.7 per 100,000, caused by the trinucleotide CAG (cytosine, adenine, guanine) repeat expansion in the HTT gene. HD is characterized by a range of motor, cognitive, and psychiatric symptoms, the latter of which usually manifest prior to the onset of motor or cognitive disturbances. Amongst psychiatric symptoms, changes in personality are most common, followed by depression. Psychosis has a higher prevalence in those with early-onset HD. Objectives This case report aims to demonstrate an apporach to the management of neuropsychiatric disturbances in HD as well as expose the need for development of an evidence-based apprach to treatment. Methods PubMed was searched for the criteria Huntington’s Disease AND Psychosis, with a secondary search for Management of Psychosis in Huntington’s Disease. Results The patient is a 54-year-old male with no psychiatric history and reported past medical history of Huntington’s Disease, diagnosed one month ago. He was brought to the Psychiatric ED due to agitation and disorganized behavior at home. On admission, he demonstrated disorganized behavior, grandiose delusions, neurocognitive deficits, and reported auditory hallucinations. With the initiation of tetrabenazine and risperidone his psychiatric symptoms improved and he was able to be discharged to a long-term care facility. Conclusions Literature is scarce regarding treatment of psychiatric manifestations of HD. We catered our approach towards safe and effective symptoms management in a multidisciplinary manner. Further research is required to reach an evidence-based consensus as well as develop specific guidelines for managing psychiatric conditions related to HD. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822012081/type/journal_articleNeuropsychiatryHuntington’s diseasePsychosis |
| spellingShingle | J. Jay V. Kumar P. Bidkhanian E. Garrels Y. Segal B. Susaimanickam Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management European Psychiatry Neuropsychiatry Huntington’s disease Psychosis |
| title | Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management |
| title_full | Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management |
| title_fullStr | Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management |
| title_full_unstemmed | Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management |
| title_short | Neuropsychiatric Disturbance in Huntington’s Disease: Approach to Management |
| title_sort | neuropsychiatric disturbance in huntington s disease approach to management |
| topic | Neuropsychiatry Huntington’s disease Psychosis |
| url | https://www.cambridge.org/core/product/identifier/S0924933822012081/type/journal_article |
| work_keys_str_mv | AT jjay neuropsychiatricdisturbanceinhuntingtonsdiseaseapproachtomanagement AT vkumar neuropsychiatricdisturbanceinhuntingtonsdiseaseapproachtomanagement AT pbidkhanian neuropsychiatricdisturbanceinhuntingtonsdiseaseapproachtomanagement AT egarrels neuropsychiatricdisturbanceinhuntingtonsdiseaseapproachtomanagement AT ysegal neuropsychiatricdisturbanceinhuntingtonsdiseaseapproachtomanagement AT bsusaimanickam neuropsychiatricdisturbanceinhuntingtonsdiseaseapproachtomanagement |