The use of olanzapine in Huntington disease accompanied by psychotic symptoms

Yıl 2014, , - , 01.06.2014

Cafer Alhan Taha Can Tuman Nefise Kayka Osman Yıldırım Tarık Eroğlu

https://doi.org/10.5799/ahinjs.01.2014.02.0414

Öz

Huntington's disease is an autosomal dominant neurodegenerative disease. The disease begins between the ages of 30-50, including motor symptoms, psychiatric symptoms and is characterized by progressive dementia. Common psychiatric disorders of Huntington\'s disease include mood and anxiety disorders, behavior and personality changes. Psychosis is relatively rare. Here, a patient is present, who has Huntington\'s disease, which is associated with psychotic symptoms. 61-year-old male patient who were followed for Huntington disease for 25 years was admitted for complaints of thinking of poisoning and refuse to eat something. Patient was started on olanzapine at dose of 5 mg/day. In follow up psychotic symptoms disappeared. Emerging psychotic symptoms in Huntington disease is created a need for antipsychotic treatment. Atypical antipsychotic agents should be preferred in the treatment and as in the case olanzapine may be used as a treatment option should be kept in mind to control both involuntary movements and psychotic symptoms in Huntington's disease with psychotic features. J Clin Exp Invest 2014; 5 (2): 326-328

Anahtar Kelimeler

Huntington, olanzapine, psychosis

Psikotik belirtilerin eşlik ettiği Huntington hastalığında olanzapin kullanımı

Öz

Huntington hastalığı otozomal dominant geçişli, nörodejeneratif bir hastalıktır. Hastalık 30-50 yaşlar arasında başlayan motor belirtiler olmak üzere, psikiyatrik belirtiler ve ilerleyici demans ile karakterizedir. Huntington hastalığında görülen psikiyatrik bozukluklar sıklıkla duygu durum ve anksiyete bozuklukları, davranış ve kişilik değişiklikleridir. Psikoz ise nisbeten nadir görülür. Bu sunumda psikotik belirtilerle seyreden bir Huntington olgusu sunulacaktır. 25 yıldır Huntington hastalığı nedeniyle takip edilen 61 yaşında erkek hasta zehirlendiğini düşünme ve yemek yemeyi reddetme şikayetleri ile başvurdu. Hastaya olanzapin 5 mg/gün tedavisi başlandı. İzlemlerde psikotik belirtileri ortadan kalktı. Huntington hastalığında ortaya çıkan psikotik belirtiler, antipsikotik tedavi ihtiyacı oluşturmaktadır. Tedavide atipik antipsikotikler tercih edilmeli ve bu olguda olduğu gibi olanzapin, psikotik belirtilerin eşlik ettiği Huntington olgularında psikozu ve istemsiz hareketleri kontrol altına almada tedavi seçeneği olarak akılda tutulmalıdır.

Anahtar Kelimeler

Huntington, olanzapin, psikoz

Kaynakça

• Adams RD, Victor M, Ropper A. Principles of Neurol- ogy. 6th ed. New York: McGraw-Hill; 1998:1060-1064.
• Bradley W, Daroff RB, Fenichel G, Marsden CD. Neu- rology in Clinical Practice. 3rd ed. In: Walter G, ed. Boston:1985:1914-1915. 328
• Hurley RA, Jackson EF, Fisher RE, Taber KH. New techniques for understanding Huntington’s disease. J Neuropsychiatry Clin Neurosci 1999;11:173-175.
• Lastres-Becker I, De Miguel R, Fernandez-Ruiz JJ. The endocannabinoid system and Huntington’s disease. Curr Drug Targets CNS Neurol Disord 2003;2:335- 347.
• Leroi I, Michalon M. Treatment of the psychiatric mani- festations of Huntington’s disease: A review of the lit- erature. Can J Psychiatry 1998;43:933-940.
• Madhusoodanan S, Brenner R, Moise D, et al. Psy- chiatric and neuropsychological abnormalities in Hun- tington’s disease: A case study. Ann Clin Psychiatry 1998;10:117-120.
• Lovestone S, Hodgson S, Sham P, et al.; Familial psy- chiatric presentation of Huntington’s disease. J Med Genet 1996;33:128-131.
• Weigell-Weber M, Schmid W, Spiegel R. Psychiatric symptoms and CAG expansion in Huntington’s dis- ease. Am J Med Genet 1996;67:53-57.
• Berrios GE, Wagle AC, Markova IS, et al. Psychiatric symptoms and CAG repeats in neurologically asymp- tomatic Huntington’s disease gene carriers. Psychia- try Res 2001;102:217-225.
• Girotti F, Carella F, Scigliano G, et al. Effect of neuro- leptic treatment on involuntary movements and motor performances in Huntington’s disease. J Neurol Neu- rosurg Psychiatry 1984;47:848-852.
• Schoulson I. Care of patients and families with Hun- tington’s disease. 1st ed. In: Marsden CD, Fahn, ed. Movement Disorders. London: Buttersworth; 1982. p.277-290.
• Schott K, Ried S, Stevens I, Dichgans J. Neurolepti- cally induced dystonia in Huntington’s disease: A case report. Eur Neurol 1989;29:39-40.
• Paleacu D, Anca M, Giladi N. Olanzapine in Hunting- ton’s disease. Acta Neurol Scand 2002;105:441-444.
• Madhusoodenan S, Brenner R. Use of resperidone in psychosis associated with Huntington’s disease. Am J Ger Psychiatry 1998;6:347-349.
• Erdemoglu AK, Boratav C. Risperidone in chorea and psychosis of Huntington’s disease. Eur J Neurol 2002;9:182-183.
• Vallette N, Gosselin O, Kahn JP. Efficacy of clozapine in the course of Huntington chorea: Apropos of a clini- cal case. Encephale 2001;27:169-171.
• Evans DL, Pedersen CA, Tancer ME. ECT in the treat- ment of organic psychosis in Huntington’s disease. Convuls Ther 1987;3:145-150.