Psychiatric Disorders (TBZ)

Treatments of HD do not cure, change, slow down or reverse the progression of HD. Most treatments main goal is to suppress the symptoms as much as possible and so enabling the patient to live a normal life a bit longer. Treatments available for HD are drugs for movement and psychiatric disorders, and psychotherapy, speech, physical and occupational therapy.
6.1 Medications for Movement Disorders
There are several drugs used to treat chorea. The drug tetrabenazine (TBZ) was the first drug approved by FDA in the US to treat chorea in 2008. However, TBZ has some serious side effects, because it can trigger or worsen psychiatric disorders like depression.
Antipsychotic drugs such as haloperidol and chlorpromazine have a side effect of suppressing

Mood changes are managed with mood-stabilizing drugs, such as carbamazepine or valproate. Side effects for this kind of drugs include weight gain, tremors and gastrointestinal problems.
To treat depression, antidepressants, such as citalopram or fluoxetine, are taken. Their side effects include nausea, trembling and insomnia. Antipsychotic medication is used to treat psychosis or violent outburst from HD patients.
6.3 Psychotherapy
The goal of this psychotherapy is to help HD patient to cope with their illness and followed symptoms. Showing HD patient coping mechanism and helping them managing the progression of HD as well as their expectation is vital to avoid psychiatric disorders, like depression.
6.4 Speech Therapy
In speech therapy the main goal is to enable a HD patient to communicate by himself for as long as possible. In early stages of HD the focus lies on developing strategies to compensate for communication, swallowing and cognitive problems experienced. Later on, the focus shifts to maintain swallowing and communication at the highest level possible.
6.5 Physical and Occupational

Fifteen HD patients participated in the study over 9 months. It consisted of once a week supervised clinical exercise, three times a week home exercise and all fourteen days occupational therapy. Participants were evaluated using MRI images and validate cognitive measures at the beginning and after 9 months.
The results displayed a significantly increase in the gray matter volume of the brain as well as considerable improvements in verbal learning and memory. This suggested an important link between gray matter volume and verbal learning and memory performance, see Fig.4.
The study concluded that multidisciplinary rehabilitation had a positive impact on the gray matter and cognitive abilities of HD patients.
Multidisciplinary rehabilitation provides a new treatment to slow down HD progression without the use of drugs. Therefore, it is more feasible for all HD patients, since side effects on the therapy are less serious than the ones resulted from