Vulnerability to neuroleptic side effects in frontotemporal lobar degeneration.
BACKGROUND
Frontotemporal lobar degeneration (FTLD) is commonly associated with behavioural disturbances such as disinhibition and aggression; these often result in the use of neuroleptic medication.


METHODS
All available case notes of patients attending a specialist cognitive disorders clinic with a diagnosis of FTLD were selected. This gave 100 subjects (62 male, 38 female).


RESULTS
In 61 patients significant behavioural disturbances were present. Of these patients, 24 had been prescribed neuroleptics. Significant extrapyramidal side effects were reported in eight patients (33%); in five patients these were severe enough to cause severe mobility problems and in one patient resulted in impaired consciousness. In some instances the extrapyramidal side effects took weeks to wear off.


CONCLUSIONS
These results suggest that patients with FTLD may, as in Lewy body dementia, be particularly sensitive to the extrapyramidal side effects of neuroleptics. We suggest that neuroleptics should be used cautiously in FTLD and treatment should be started at low doses avoiding depot preparations until further prospective studies have been performed.
Pijnenburg
Y A L
YA
Department of Clinical Neurology, Institute of Neurology, London, UK.
Sampson
E L
EL
Harvey
R J
RJ
Fox
N C
NC
Rossor
M N
MN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001284:Atrophy; D001480:Basal Ganglia Diseases / Q000139:chemically induced*; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012920:Social Behavior Disorders / Q000188:drug therapy / Q000209:etiology; D013702:Temporal Lobe / Q000473:pathology
D014150:Antipsychotic Agents