Lenz B, Sidiropoulos C, Bleich S, Kornhuber J
Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6-10, Erlangen.
Fortschr Neurol Psychiatr. 2009 May;77(5):289-94. doi: 10.1055/s-0028-1109403. Epub 2009 May 5.
Frontotemporal dementia is more frequently diagnosed because of revised diagnostic procedures. Due to the lack of pharmacological trials it is a disease that is difficult to manage in the way of evidence based medicine. Deficits in serotonergic and dopaminergic signal-transmission are well known. The cholinergic system does not seem to be affected. Case reports and clinical trials show a benefit by using antidepressants, neuroleptics and mood stabilizers. Nevertheless only paroxetine, trazodone and rivastigmine are tested by double-blind, placebo-controlled studies. While paroxetine shows inconsistent data, trazodone improves behavioural symptoms. Patients report a treatment-emergent adverse effect including fatigue, dizziness and hypotension. Rivastigmine leads to a significant decrease in the Neuropsychiatric Inventory Score. Finally, we present a two-cases-report that shows improve of disease symptoms under treatment with repetitive transcranial magnet stimulation.