title: Treatment of psychotic and behavioral symptoms with clozapine, aripiprazole, and reboxetine in a patient with Huntington's disease.
abstract: We report on the successful use of a combined psychopharmacological treatment in a patient with Huntington's disease, at age 39, suffering from severe psychotic and behavioral symptoms. He presented with a schizophreniform psychosis accompanied by aggressive behavior leading to admission to the locked ward of our hospital. After unsatisfactory control of the psychiatric symptoms with olanzapine, risperidone, and amisulpride, we introduced aripiprazole. This did not affect the psychotic symptoms; however, led to an improvement in aggressive behavior, motivation, and even chorea. Accordingly, we choose not to switch medication but to add clozapine. Nevertheless, his delusions improved slightly, and further add-on treatment with reboxetine brought a further beneficial effect on motivation and activities of daily living. As chorea was not disabling in our patient, tetrabenazine has not yet been tried. Treatment was safe without any relevant side effects.
authors: Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Medical University Innsbruck, Innsbruck, Austria. monika.edlinger@uki.at
authors: Monika
authors: M
authors: Edlinger
authors: Klaus
authors: K
authors: Seppi
authors: Wolfgang
authors: W
authors: Fleischhacker
authors: Alex
authors: A
authors: Hofer
mesh_terms: D000328:Adult; D000374:Aggression / Q000187:drug effects*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole; D003024:Clozapine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D006816:Huntington Disease / Q000523:psychology*; D008297:Male; D009025:Morpholines / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology; D015363:Quinolones / Q000627:therapeutic use*; D000077593:Reboxetine; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D009025:Morpholines; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole; D000077593:Reboxetine; D003024:Clozapine