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Olanzapine in Huntington's disease
1Neurological Service and Memory Clinic, Abarbanel Mental Health Center, Keren Kayemet, Bat Yam, Sackler School of Medicine, Tel Aviv University, Israel. paleacu@post.tau.ac.il
Insights
Olanzapine (OL) effectively treats psychiatric symptoms in Huntington
Area of Science:
- Neuroscience
- Pharmacology
- Neurology
Background:
- Huntington's disease (HD) is a progressive neurodegenerative disorder.
- Managing psychiatric and motor symptoms in HD patients is challenging.
- Olanzapine (OL) is an atypical antipsychotic with potential therapeutic applications in neurological conditions.
Purpose of the Study:
- To evaluate the efficacy and safety of olanzapine (OL) in patients diagnosed with Huntington's disease (HD).
- To assess the impact of OL on both behavioral and motor symptoms associated with HD.
Main Methods:
- A cohort of eleven Huntington's disease patients received olanzapine treatment.
- Assessments included the Clinical Global Impression of Change Scale (CGIC) and the Unified Huntington's Disease Rating Scale (UHDRS) for behavioral (UHDRS-b) and motor (UHDRS-m) functions.
- Data collected at 6-month intervals over a treatment period averaging 9.8 months.
Main Results:
- Significant improvement was observed in behavioral symptoms (UHDRS-b, P < 0.0001).
- Motor symptoms (UHDRS-m) showed no significant change.
- Five patients experienced improvement in chorea; two discontinued treatment due to adverse effects or lack of efficacy.
Conclusions:
- Olanzapine demonstrates potential as an alternative treatment for Huntington's disease, particularly for psychiatric manifestations.
- The drug shows moderate effectiveness for motor symptoms, potentially linked to its impact on chorea.
- Recommended for adult-onset HD patients with severe chorea and/or significant psychiatric disturbances.
Objectives:
To study the effect of olanzapine (OL) in Huntington's disease (HD) patients.
Design And Methods:
Eleven HD patients (five men), aged 47.6 +/- 11.4 years and with disease duration of 11.2 +/- 3.3 years received OL. Assessment was carried out using the Clinical Global Impression of Change Scale (CGIC) and the Unified Huntington's Disease Rating Scale behavioral (UHDRS - b) and motor (UHDRS - m) at 6 month intervals.
Results:
Nine patients were treated for 9.8 +/- 5.9 months. The mean OL dose/patient was 11.4 +/- 8.5 mg/day (median 10 mg/day). Mean CGIC was 2.1 +/- 0.8. UHDRS - b improved significantly (P < 0.0001) and UHDRS - m did not change. Chorea improved in five patients and two dropped out because of drug eruption and lack of efficacy.
Conclusion:
OL is a good alternative treatment in HD, mainly for the psychiatric symptoms and moderately effective for the motor symptoms, possibly because of its effect on chorea. We suggest OL should be used in HD patients with the adult onset form, severe chorea and/or severe psychiatric disturbances.