Archive 1992–2014

Aim. To present an update on available options for the frontotemporal dementia (FTD) treatment.
Review. FTD is an umbrella term describing a group of primarily degenerative dementias characterised by a restricted atrophy in the frontal and anterior temporal lobes. The primary feature of FTD is a predominance of severe behavioral and/or language disorders over memory problems typical of Alzheimer's disease (AD). Studies conducted to evaluate the efficacy of various FTD treatment methods are scarce, involve small patient groups, frequently lack methodological rigor, and as a rule evaluate medications that have purely symptomatic action on behavioral disturbances typical of FTD.
Conclusions. The basic option for the treatment of FTD behavioral disorders are serotonergic medications – SSRIs and trazodone. Symptoms that might respond to the serotonergic treatment include disinhibition, impulsivity, dysphoria, depression, anxiety, overeating and stereotypic behaviors. In case of patient behaviors threatening his/her or caregivers' safety, the introduction of atypical antipsychotic medications may be justified, preferably neuroleptics with a low D2 receptor affinity (considering the high risk of extrapyramidal symptoms in FTD patients). Unfortunately, no FTD treatment methods that can enhance cognition or slow disease progression are available yet. Cholinesterase inhibitors and memantine turned out to be ineffective in this regard, which may be due to a different pattern of neurochemical changes in FTD as compared to these in other types of primarily degenerative dementias. Preliminary results of the treatment with dopaminergic medications (moclobemide, selegiline, stimulants) are promising, but the available data are too scant to permit a recommendation of their routine use.