Off-Label Medication Use in Frontotemporal Dementia (original) (raw)

Abstract

Objective: There are no Food and Drug Administration (FDA)-approved medications indicated for the treatment of frontotemporal dementia (FTD). We sought to determine the most commonly used drugs used to treat behavioral variant FTD (bvFTD) in specialized dementia clinics. Methods: Medication and demographic data from the Alzheimer’s Disease Research Centers of California (ARCC) and a multicenter FTD natural history study (NHS) data set were compared in bvFTD and Alzheimer’s disease (AD), and effects of demographic variables were assessed using logistic regression. Results: Overall, the percentage of patients taking one or more FDA-approved AD or psychiatric medications was similar in bvFTD and AD; however, after controlling for demographic variables, acetylcholinesterase inhibitor (AChI) use was less common in bvFTD, whereas memantine use remained similar in the 2 groups. Conclusions: Despite lack of evidence for efficacy, the use of AChIs and memantine is common in bvFTD. Clinical trials should be pursued to determine the optimal therapeutic interventions for bvFTD.

Keywords: frontotemporal dementia, Alzheimer’s disease, treatment, donepezil, memantine, galantamine, antipsychotic agents

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Contributor Information

Bei Hu, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.

Leslie Ross, Institute for Health and Aging, University of California, San Francisco, CA, USA.

John Neuhaus, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.

David Knopman, Department of Neurology, Mayo Clinic, Rochester, MN, USA.

Joel Kramer, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.

Bradley Boeve, Department of Neurology, Mayo Clinic, Rochester, MN, USA.

Richard J. Caselli, Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.

Neill Graff-Radford, Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.

Mario F. Mendez, Department of Neurology, University of California, Los Angeles, CA, USA.

Bruce L. Miller, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.

Adam L. Boxer, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA, aboxer@memory.ucsf.edu .

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