Treatment Options for PSP, CBD, and FTD (Review)

This medical journal article is a review of what we know about treatment of PSP (progressive supranuclear palsy), CBD (corticobasal degeneration), and FTD (frontotemporal dementia). Some general statements are made about “diet and lifestyle,” then several medications are discussed including anti-depressants (SSRIs in particular), dementia medications, antipsychotics, and levodopa. Finally, “emerging therapies” are briefly described.

I’ve copied the abstract below.

For me, the one new piece of information is that Abilify and Seroquel are the two most commonly prescribed antipsychotics “in parkinsonian disorders.” It would be interesting to know how frequently they are prescribed in PSP and CBD. Certainly most of the prescriptions are for Parkinson’s Disease and Parkinson’s Disease Dementia (Lewy Body Dementia). Though we have a few local support group members with PSP and CBD taking these medications, the majority do not.



Current Treatment Options in Neurology. 2012 Feb 4. [Epub ahead of print]

Treatment Options for Tauopathies.

Karakaya T, Fußer F, Prvulovic D, Hampel H.
Department of Psychiatry, J.W. Goethe-University, Frankfurt, Germany.

OPINION STATEMENT: To date, there are no approved and established pharmacologic treatment options for tauopathies, a very heterogenous group of neuropsychiatric diseases often leading to dementia and clinically diagnosed as atypical Parkinson syndromes.

Among these so-called Parkinson plus syndromes are progressive supranuclear palsy (PSP), also referred to as Steele-Richardson-Olszewski syndrome; frontotemporal dementia (FTD); and corticobasal degeneration (CBD).

Available treatment strategies are based mainly on small clinical trials, miscellaneous case reports, or small case-controlled studies. The results of these studies and conclusions about the efficacy of the medication used are often contradictory.

Approved therapeutic agents for Alzheimer´s dementia, such as acetylcholinesterase inhibitors and memantine, have been used off-label to treat cognitive and behavioral symptoms in tauopathies, but the outcome has not been consistent.

Therapeutic agents for the symptomatic treatment of Parkinson’s disease (levodopa or dopamine agonists) are used for motor symptoms in tauopathies.

For behavioral or psychopathological symptoms, treatment with antidepressants-especially selective serotonin reuptake inhibitors-could be helpful.

Antipsychotics are often not well tolerated because of their adverse effects, which are pronounced in tauopathies; these drugs should be given very carefully because of an increased risk of cerebrovascular events.

In addition to pharmacologic options, physical, occupational, or speech therapy can be applied to improve functional abilities.

Each pharmacologic or nonpharmacologic intervention should be fitted to the specific symptoms of the individual patient, and decisions about the type and duration of treatment should be based on its efficacy for the individual and the patient’s tolerance.

Currently, no effective treatment is available that targets the cause of these diseases. Current research focuses on targeting tau protein pathology, including pathologic aggregation or phosphorylation; these approaches seem to be very promising.

PubMed ID: #22307450 (see for this abstract only)