Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

Antipsychotics

6 evidence topics · 8 sources

EHDN international guideline: second-generation neuroleptics for chorea and psychiatric symptoms

“are first-line treatments for this symptom in particular when the patients have associated personality and/or behavioral or psychotic disorders. Monotherapy to treat chorea is preferred because combination therapy increases the risk of adverse effects and may complicate the management of non-motor symptoms.” (opens the source at this quote in a new tab)
“Second generation neuroleptics are the first line treatment for hallucinations and delusions (Grade C)” (opens the source at this quote in a new tab)
“In patients with aggressive behavior, the recommended first-line treatment is a neuroleptic (Grade C)” (opens the source at this quote in a new tab)

German Neurological Society guideline: tiapride as first-line antichoreic treatment

“Because of the favorable profile of side effects, in particular with regard to extrapyramidal (akathisia, Parkinsonism) and behavioral (depression) symptoms, the consensus in the Delphi group was that tiapride should be considered as first line treatment.” (opens the source at this quote in a new tab)
“Comparative studies (comparing head-to-head compounds for their ability to suppress hyperkinesias short- and long-term) are unavailable.” (opens the source at this quote in a new tab)

AAN guideline (retired 2022): insufficient data for neuroleptics

“Data are insufficient to make recommendations regarding the use of neuroleptics or donepezil for HD chorea treatment (Level U).” (opens the source at this quote in a new tab)

HDSA physician's guide: off-label neuroleptics for chorea

“Individuals who do not tolerate tetrabenazine, or have other contraindications to its use, may benefit from off-label use of neuroleptics for reduction in chorea.” (opens the source at this quote in a new tab)
“Side effects of neuroleptics include apathy, sedation, akathisia, worsening of voluntary motor control, tardive dyskinesia and neuroleptic malignant syndrome.” (opens the source at this quote in a new tab)

International expert survey: first-choice antichoreic drug by region

“However, the experts did not agree on first choice of chorea drug, with the majority of experts in Europe favoring an antipsychotic drug (APD), and a near equal split in first choice between an APD and tetrabenazine (TBZ) among experts from North America and Australia.” (opens the source at this quote in a new tab)

Olanzapine: one-year randomized open-label trial

“Olanzapine improved chorea, behavior, and irritability, although with a slight increase in rigidity.” (opens the source at this quote in a new tab)