Addressing Behavior Changes in Huntington DiseaseRon Risley MD, HDSA Center of Excellence, UCDMC
Types of Changes classic psychiatric symptoms: mood changes, anxiety, psychosis inanition (lethargy, disinterest) anger outbursts Treatments "use it or lose it" start early stimulating -- but not confusing -- environment daily exercise, particularly outdoors diet: varied, nutritious, omega-3 fatty acids, "if you drink, your brain will shrink" "variety is the spice of life" time outs psychotherapy expensive and hard to get self-directed therapy such as CBT "The Feeling Good Handbook" David Burns, MD medications some psychiatrists are reluctant to treat HD, as they are unlikely to have experience with it most symptoms are treated the same as in non-HD patients medications treat only symptoms, but increase opportunities for making environmental changes and engaging in psychotherapy Executive Function ability to plan and follow through with tasks wide range of individual baseline capability start early and make planning a mechanical process central point of planning desk blotter calendar sticky notes for "to do" items medications and telephone next to calendar support, but not preemption, from caregivers start early tune the environment use it or lose it get medical consultation mechanize executive functions