Pharmacotherapy for Neuropsychiatric Symptoms in Frontotemporal Dementia

CNS Drugs. 2021 Oct;35(10):1081-1096. doi: 10.1007/s40263-021-00854-5. Epub 2021 Aug 24.

Abstract

Despite significant progress in the understanding of the frontotemporal dementias (FTDs), there remains no disease-modifying treatment for these conditions, and limited effective symptomatic treatment. Behavioural variant frontotemporal dementia (bvFTD) is the most common FTD syndrome, and is characterized by severe impairments in behaviour, personality and cognition. Neuropsychiatric symptoms are common features of bvFTD but are present in the other FTD syndromes. Current treatment strategies therefore focus on ameliorating the neuropsychiatric features. Here we review the rationale for current treatments related to each of the main neuropsychiatric symptoms forming the diagnostic criteria for bvFTD relevant to all FTD subtypes, and two additional symptoms not currently part of the diagnostic criteria: lack of insight and psychosis. Given the paucity of effective treatments for these symptoms, we highlight how contributing mechanisms delineated in cognitive neuroscience may inform future approaches to clinical trials and more precise symptomatic treatments for FTDs.

Publication types

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

MeSH terms

  • Antipsychotic Agents / therapeutic use
  • Dopamine Agents / therapeutic use
  • Frontotemporal Dementia / diagnosis
  • Frontotemporal Dementia / drug therapy*
  • Frontotemporal Dementia / psychology*
  • Humans
  • Inhibition, Psychological*
  • Mental Disorders / diagnosis
  • Mental Disorders / drug therapy
  • Mental Disorders / psychology
  • Neuropsychological Tests*
  • Randomized Controlled Trials as Topic / methods

Substances

  • Antipsychotic Agents
  • Dopamine Agents

Grants and funding