Treatment of the psychiatric manifestations of Huntington's disease: A review of the literature

Objective: To review the clinical management of the psychiatric aspects of Huntington's disease (HD), namely the mood disorders, psychotic disorders, anxiety symptoms, sleep disorders, disorders of sexuality, and the behavioural changes of apathy, irritability, and aggression. Emphasis is on pharmacologic and psychotherapeutic intervention strategies. In addition, the role of psychiatric intervention in presymptomatic testing is explored. Method: English language literature on the pharmacologic and psychotherapeutic management of the psychiatric manifestations of HD between 1976 and 1996 was critically reviewed. Results: Few sound studies address the clinical management of the psychiatric aspects of HD; thus, only the broadest conclusions can be drawn. Pharmacologic strategies for the treatment of psychiatric aspects of HD were organized according to the therapeutic agent and class, and psychotherapeutic strategies were discussed. Conclusion: The clinical management of the psychiatric manifestations of HD requires much more complete and systematic study before any definite conclusions as to efficacy of various approaches can be drawn.