piperidines and Frontotemporal-Dementia

Topics: Apathy; Behavioral Symptoms; Delusions; Donepezil; Follow-Up Studies; Frontotemporal Dementia; Humans; Indans; Irritable Mood; Nootropic Agents; Pilot Projects; Piperidines; Psychomotor Agitation; Risk Assessment

Topics: Adult; Behavioral Symptoms; Cholinesterase Inhibitors; Confusion; Donepezil; Frontotemporal Dementia; Humans; Indans; Male; Piperidines

Sequential therapeutic trials for catatonoid frontal signs in clinically-evident frontotemporal dementia (n = 2) revealed differential benefits for lorazepam, amantadine, memantine, pramipexole, aripiprazole, quetiapine, citalopram, and donepezil, although certain signs also worsened. Citalopram and donepezil were poorly tolerated. Ramelteon was without effect. While memantine appeared to improve cognition in case 1, this remains to be established by more reliable neuropsychological testing. Parkinsonism (case 2) responded to pramipexole, but not amantadine or levodopa. Possible relationships of catatonoid signs requiring future confirmation include insufficient GABA-A (multiple signs) and D2 (mutism) and excessive NMDA (immobility, rigidity), D2/D3 (mannerisms, verbal perseveration), and 5HT1a (staring) receptor stimulation. Low-dose lorazepam and quetiapine required close monitoring.

Topics: Aged; Amantadine; Antipsychotic Agents; Aripiprazole; Benzothiazoles; Catatonia; Citalopram; Clinical Trials as Topic; Dibenzothiazepines; Donepezil; Dopamine Agents; Excitatory Amino Acid Antagonists; Female; Frontotemporal Dementia; Humans; Hypnotics and Sedatives; Indans; Lorazepam; Memantine; Middle Aged; Nootropic Agents; Piperazines; Piperidines; Pramipexole; Quetiapine Fumarate; Quinolones; Selective Serotonin Reuptake Inhibitors