Frontotemporal dementia: therapeutic interventions

The management of frontotemporal dementia (FTD), a disorder characterized by varied behavioral symptoms, primarily involves the use of psychoactive medications. Although there are no approved treatments for the disorder, selective serontonin receptor inhibitors, such as sertraline, paroxetine, or fluoxetine, can decrease disinhibition-impulsivity, repetitive behaviors, and eating disorders in FTD. Low doses of trazodone or an atypical antipsychotic such as aripriprazole can also help manage significantly disturbed or agitated behavior. The acetylcholinesterase inhibitors used for patients with Alzheimer's disease have not had significant efficacy for patients with FTD, but memantine, another dementia medication, is under investigation for the treatment of this disorder. In addition to drug therapy, the nonpharmacological management of patients with FTD focuses on education, behavioral interventions, and care of the caregivers. Most recently, investigators have initiated steps toward rational drug therapy with the development of outcome measures for clinical drug trials in FTD and the characterization of treatment targets such tau protein or the TAR DNA-binding protein 43. This approach holds great promise for an eventual treatment for this devastating early-onset dementia.