[Frontotemporal dementia: neurotransmitter and clinical symptoms with focus on therapeutic targets].
Frontotemporal dementia is more frequently diagnosed because of revised diagnostic procedures. Due to the lack of pharmacological trials it is a disease that is difficult to manage in the way of evidence based medicine. Deficits in serotonergic and dopaminergic signal-transmission are well known. The cholinergic system does not seem to be affected. Case reports and clinical trials show a benefit by using antidepressants, neuroleptics and mood stabilizers. Nevertheless only paroxetine, trazodone and rivastigmine are tested by double-blind, placebo-controlled studies. While paroxetine shows inconsistent data, trazodone improves behavioural symptoms. Patients report a treatment-emergent adverse effect including fatigue, dizziness and hypotension. Rivastigmine leads to a significant decrease in the Neuropsychiatric Inventory Score. Finally, we present a two-cases-report that shows improve of disease symptoms under treatment with repetitive transcranial magnet stimulation.
Lenz
B
B
Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6-10, Erlangen. bernd.lenz@uk-erlangen.de
Sidiropoulos
C
C
Bleich
S
S
Kornhuber
J
J
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D018377:Neurotransmitter Agents / Q000378:metabolism / Q000502:physiology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D050781:Transcranial Magnetic Stimulation
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018377:Neurotransmitter Agents; D011619:Psychotropic Drugs