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Pharmacological management of Huntington's disease: an evidence-based review

Raphael M Bonelli1, Gregor K Wenning

  • 1University Clinic of Psychiatry, Department of Psychiatry, Graz Medical University, Auenbruggerplatz 31, A-8036 Graz, Austria. raphael.bonelli@klinikum-graz.at

Current Pharmaceutical Design
|July 18, 2006
PubMed

Insights

This review found poor evidence for current Huntington's disease (HD) treatments. High-quality randomized controlled trials are needed to establish effective pharmacological interventions for HD management.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Clinical Trials

Background:

  • Huntington's disease (HD) is a neurodegenerative disorder with limited evidence-based pharmacological treatments.
  • A comprehensive evidence-based review of HD treatment studies has been lacking.

Purpose of the Study:

  • To systematically review and analyze published studies on pharmacological interventions for Huntington's disease.
  • To assess the efficacy, safety, and tolerability of various compounds used in HD management.

Main Methods:

  • Systematic literature searches of Medline and the Cochrane Library (1965-2005).
  • Classification of studies into Level-I (RCTs), Level-II (non-randomized controlled trials), and Level-III (open label trials).
  • Analysis of efficacy and safety data for each compound.

Main Results:

  • 218 publications on HD pharmacological interventions were identified and analyzed.
  • Limited evidence suggests haloperidol, fluphenazine, and olanzapine may be useful for chorea.
  • Investigational treatments exist for chorea, rigidity, depression, psychosis, and behavioral symptoms, with very low evidence for some.

Conclusions:

  • Current management of Huntington's disease lacks robust evidence-based treatment recommendations.
  • The reviewed Level-I studies do not provide clinically relevant treatment guidance.
  • High-quality randomized controlled trials are urgently needed to advance clinical practice in HD treatment.
Abstract

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