Physicians may prescribe a number of medications to help control
emotional and movement problems associated with Huntington's
disease (HD). It is important to remember however, that while
medicines may help keep these clinical symptoms under control,
there is no treatment to stop or reverse the course of the
disease.
- Movement and emotional problems
Antipsychotic drugs, such as
haloperidol,
or other drugs,
such as
clonazepam
, may help to alleviate choreic movements
and may also be used to help control hallucinations, delusions, and
violent outbursts. Antipsychotic drugs, however, are not prescribed
for another form of muscle contraction associated with HD, called
dystonia, and may in fact worsen the condition, causing stiffness
and rigidity. These medications may also have severe side effects,
including sedation, and for that reason should be used in the
lowest possible doses.
- Depression and anxiety
For depression, physicians may prescribe
fluoxetine
,
sertraline,
nortriptyline
, or other compounds. Tranquilizers
can help control anxiety and
lithium
may be prescribed to
combat pathological excitement and severe mood swings. Medications
may also be needed to treat the severe obsessive-compulsive rituals
of some individuals with HD.
Most drugs used to treat the symptoms of HD have side effects
such as fatigue, restlessness, or hyper-excitability. Sometimes it
may be difficult to tell if a particular symptom, such as apathy or
incontinence, is a sign of the disease or a reaction to
medication.
- Consult a neurologist
Although a psychologist or psychiatrist, a genetic counselor, and
other specialists may be needed at different stages of the illness,
usually the first step in diagnosis and in finding treatment is to
see a neurologist. While the family doctor may be able to diagnose
HD, and may continue to monitor the individual's status, it is
better to consult with a neurologist about management of the varied
symptoms.
- Reduce communication problems
Problems may arise when individuals try to express complex
thoughts in words they can no longer pronounce intelligibly. It can
be helpful to repeat words back to the person with HD so that he or
she knows that some thoughts are understood. Sometimes people
mistakenly assume that if individuals do not talk, they also do not
understand. Never isolate individuals by not talking, and try to
keep their environment as normal as possible.
Speech therapy
may improve the individual's ability to communicate.
- Maintain physical fitness and safety
It is extremely important for the person with HD to maintain
physical fitness as much as his or her condition and the course of
the disease allows. Individuals who exercise and keep active tend
to do better than those who do not. A daily regimen of exercise can
help the person feel better physically and mentally. Although their
coordination may be poor, individuals should continue walking, with
assistance if necessary. Those who want to walk independently
should be allowed to do so as long as possible, and careful
attention should be given to keeping their environment free of
hard, sharp objects. This will help ensure maximal independence
while minimizing the risk of injury from a fall. Individuals can
also wear special padding during walks to help protect against
injury from falls. Some people have found that small weights around
the ankles can help stability. Wearing sturdy shoes that fit well
can help too, especially shoes without laces that can be slipped on
or off easily.
- Prevent swallowing difficulties
Impaired coordination may make it difficult for people with HD to
feed themselves and to swallow. As the disease progresses, persons
with HD may even choke. In helping individuals to eat, caregivers
should allow plenty of time for meals. Food can be cut into small
pieces, softened, or pureed to ease swallowing and prevent choking.
While some foods may require the addition of thickeners, other
foods may need to be thinned. Dairy products, in particular, tend
to increase the secretion of mucus, which in turn increases the
risk of choking. Some individuals may benefit from swallowing
therapy, which is especially helpful if started before serious
problems arise. Suction cups for plates, special tableware designed
for people with disabilities, and plastic cups with tops can help
prevent spilling. The individual's physician can offer additional
advice about diet and about how to handle swallowing difficulties
or gastrointestinal problems that might arise, such as incontinence
or constipation.
- Address nutritional concerns
Caregivers should pay attention to proper nutrition so that the
individual with HD takes in enough calories to maintain his or her
body weight. Sometimes people with HD, who may burn as many as
5,000 calories a day without gaining weight, require five meals a
day to take in the necessary number of calories. Physicians may
recommend vitamins or other nutritional supplements. In a long-term
care institution, staff will need to assist with meals in order to
ensure that the individual's special caloric and nutritional
requirements are met. Some individuals and their families choose to
use a feeding tube; others choose not to.
Individuals with HD are at special risk for dehydration and
therefore require large quantities of fluids, especially during hot
weather. Bendable straws can make drinking easier for the person.
In some cases, water may have to be thickened with commercial
additives to give it the consistency of syrup or honey.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
medical condition.
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2007
EBSCO Publishing All rights reserved.