Differential pharmacological responses of catatonia-like signs in frontotemporal dementia.
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.
Lauterbach
Edward C
EC
Mercer University School of Medicine, Macon, GA 31201, USA. eclbgnp@earthlink.net
Kuppuswamy
Preetha Sharone
PS
Greenway
Lauren L
LL
D000368:Aged; D000547:Amantadine / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000068180:Aripiprazole; D052160:Benzothiazoles / Q000627:therapeutic use; D002389:Catatonia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D015283:Citalopram / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003987:Dibenzothiazepines / Q000627:therapeutic use; D000077265:Donepezil; D015259:Dopamine Agents / Q000627:therapeutic use; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007189:Indans / Q000627:therapeutic use; D008140:Lorazepam / Q000627:therapeutic use; D008559:Memantine / Q000627:therapeutic use; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D000077487:Pramipexole; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D000547:Amantadine; D014150:Antipsychotic Agents; D000068180:Aripiprazole; D052160:Benzothiazoles; D015283:Citalopram; D003987:Dibenzothiazepines; D000077265:Donepezil; D015259:Dopamine Agents; D018691:Excitatory Amino Acid Antagonists; D006993:Hypnotics and Sedatives; D007189:Indans; D008140:Lorazepam; D008559:Memantine; D018697:Nootropic Agents; D010879:Piperazines; D010880:Piperidines; D000077487:Pramipexole; D000069348:Quetiapine Fumarate; D015363:Quinolones; D017367:Selective Serotonin Reuptake Inhibitors