Table I.
Symptomatic therapy in frontotemporal lobar degeneration
| Symptom | Therapy |
|---|---|
| Behavioural disturbances | Caregiver education |
| Environmental, physical and behavioural modifications | |
| Antidepressants | |
| escitalopram, citalopram, sertraline | |
| bupropion (with parkinsonism) | |
| venlafaxine (with prominent apathy) | |
| Antipsychoticsb | |
| quetiapine | |
| Aphasia | Speech therapy |
| Augmentative communication devices | |
| Parkinsonism | Physical, occupational and speech therapy |
| Levodopa/carbidopa | |
| Pramipexole, ropinirole | |
| Motor neuron disease | Multidisciplinary treatment |
| neurologic | |
| nutritional | |
| pulmonary | |
| physical, occupational and speech therapy | |
| Riluzolec | |
| Bladder dysfunction | |
| upper motor neuron | Trospium chloride, darifenacin |
| lower motor neuron | Intermittent catheterization |
a
Nonpharmacological therapies are paramount, and drug therapy in isolation is unlikely to be successful. Listed pharmacological agents are based on the clinical experience of the authors, and all recommendations represent off-label use unless otherwise specified. Medications should always be started at low doses and titrated slowly.
b
Should be used as last resort and with extreme caution because of increased mortality risk.
c
US FDA-approved for the treatment of amyotrophic lateral sclerosis.