Current therapeutic options for Huntington's disease: Good clinical practice versus evidence-based approaches?
ABSTRACT Therapeutic decision‐making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. Howe...
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| Published in | Movement disorders Vol. 29; no. 11; pp. 1404 - 1413 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
15.09.2014
Wiley Subscription Services, Inc |
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| Online Access | Get full text |
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| Abstract | ABSTRACT
Therapeutic decision‐making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence‐based medicine in relation to clinical practice. © 2014 International Parkinson and Movement Disorder Society |
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| AbstractList | Therapeutic decision‐making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence‐based medicine in relation to clinical practice. © 2014 International Parkinson and Movement Disorder Society Therapeutic decision-making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence-based medicine in relation to clinical practice. Therapeutic decision-making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence-based medicine in relation to clinical practice.Therapeutic decision-making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence-based medicine in relation to clinical practice. Therapeutic decision-making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence-based medicine in relation to clinical practice. © 2014 International Parkinson and Movement Disorder Society [PUBLICATION ABSTRACT] ABSTRACT Therapeutic decision‐making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only medication for HD that has met the regulatory hurdle for approval is tetrabenazine, indicated for the treatment of chorea. However, its use has limitations, and in the setting of specific contraindications or comorbidities the treatment of choice for chorea is still the multipurpose antipsychotics. For the management of psychiatric disturbances, selective serotonin reuptake inhibitors (SSRIs) and mood stabilizers are often used, although empirical evidence is lacking. Finally, no known effective treatment is available for cognitive dysfunction in HD. We discuss the limited evidence available and current expert opinion on medical treatment of the dominant motor, psychiatric, and cognitive features of HD. This follows a brief introduction on the general principles of HD management and on evidence‐based medicine in relation to clinical practice. © 2014 International Parkinson and Movement Disorder Society |
| Author | Biglan, Kevin M. Killoran, Annie |
| Author_xml | – sequence: 1 givenname: Annie surname: Killoran fullname: Killoran, Annie email: ankilloran@hsc.wvu.edu organization: West Virginia University, West Virginia, Morgantown, USA – sequence: 2 givenname: Kevin M. surname: Biglan fullname: Biglan, Kevin M. organization: University of Rochester, New York, Rochester, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25164707$$D View this record in MEDLINE/PubMed |
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| Notes | ArticleID:MDS26014 istex:BD52CEF4BA1640552D09B140A86E849C30A34F96 ark:/67375/WNG-DZH4DW0X-M None. Complete financial disclosures and author roles may be found in the online version of this article. Relevant conflicts of interest/financial disclosures Funding agencies Dr. Killoran has nothing to report. Dr Biglan has received funding from Lundbeck, HDSA, and PCORI. He has served as a consultant for Lundbeck, KJT consulting, Psyadom Pharmaceuticals, Inc. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 |
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Therapeutic decision‐making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available.... Therapeutic decision‐making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only... Therapeutic decision-making in Huntington's disease (HD) is often guided by clinical experience, because of the limited empirical evidence available. The only... |
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| SubjectTerms | Cognition Disorders - etiology Cognition Disorders - therapy Evidence-Based Medicine expert opinion Humans Huntington Disease - complications Huntington Disease - therapy Huntington's disease Mental Disorders - etiology Mental Disorders - therapy Movement disorders Movement Disorders - etiology Movement Disorders - therapy treatment |
| Title | Current therapeutic options for Huntington's disease: Good clinical practice versus evidence-based approaches? |
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