Psychotropic medication use in Huntington's disease: A retrospective cohort study

Ruben L Andriessen; Mayke Oosterloo; Angelique Hollands; David E J Linden; Bianca T A de Greef; Albert F G Leentjens

doi:10.1016/j.parkreldis.2022.11.004

Psychotropic medication use in Huntington's disease: A retrospective cohort study

Parkinsonism Relat Disord. 2022 Dec:105:69-74. doi: 10.1016/j.parkreldis.2022.11.004. Epub 2022 Nov 7.

Authors

Ruben L Andriessen¹, Mayke Oosterloo², Angelique Hollands¹, David E J Linden³, Bianca T A de Greef⁴, Albert F G Leentjens⁵

Affiliations

¹ Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands.
² Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
³ School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands.
⁴ Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University, Maastricht, the Netherlands.
⁵ School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address: a.leentjens@maastrichtuniversity.nl.

PMID: 36379156
DOI: 10.1016/j.parkreldis.2022.11.004

Abstract

Background: Whereas the treatment of motor symptoms in Huntington's disease (HD) receives much attention, less is known about the treatment of neuropsychiatric symptoms.

Objective: We aim to give an overview of psychotropic drug use in the treatment of neuropsychiatric symptoms across disease stages in HD.

Methods: We conducted a descriptive cross-sectional study of psychotropic drug prescriptions in a large longitudinal database of HD patients, Enroll HD. Across disease stages, the number of prescriptions per medication class, as well as the registered indications for these prescriptions were listed, and compared with that in gene negative participants.

Results: Of the 8967 included HD patients, 80% were using at least one psychotropic drug, compared to 27% of gene negative participants. In HD patients, 51% of all drug prescriptions was for psychotropic drugs. The average number of psychotropic drugs used per patient increased from 1.3 in the premanifest stage to 2.5 in stage 5. With progressing disease stages, the proportion of antidepressant drug prescriptions gradually decreased from 74.1% of all prescriptions to 27.3%, and antipsychotic drug prescriptions increased from 7.0% to 38.7%. In line with this, depression and anxiety as listed indications for prescription decreased with advancing disease stages (from 63.0% to 31.5% and from 30.0% to 15.4% respectively), whereas irritability and psychosis increased (from 3.1% to 28.6% and from 0.9% to 16.0% respectively).

Conclusions: Psychotropic medication is widely prescribed in HD, for various indications. Antidepressant use decreases proportionally and antipsychotic use increases with advancing disease stages, suggesting a relative decrease in prevalence of anxiety and depression over disease stages on one hand, and a relative increase in prevalence of irritability and delusions on the other.

Keywords: Antidepressant; Antipsychotic; Huntington's disease; Neuropsychiatric symptoms; Psychopharmacology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antidepressive Agents / therapeutic use
Antipsychotic Agents* / therapeutic use
Cross-Sectional Studies
Humans
Huntington Disease* / drug therapy
Huntington Disease* / epidemiology
Huntington Disease* / psychology
Psychotropic Drugs / therapeutic use
Retrospective Studies

Substances

Psychotropic Drugs
Antipsychotic Agents
Antidepressive Agents