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Research, drugs, treatment, new diagnosis Forum for medical issues, and for the recently diagnosed (and families)

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Old 21-09-18, 12:50 PM   #1
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Default Any Research on HD and dopamine

Hi My wife is now in a specialist centre, and my on has been tested positive so I start again on another 19 years trying to help someone I love, But I have a question that has not come up in any conversations in all the period I have been trying to Help my wife with HD, I will give you a few additional symptoms that he had and My son has now even though no movement dissorders yet only 30,

Easily angered, Aggresive
getting addicted to coffee, alcohol, cigarettes
very competitive, little or no empathy for others
has spending sprees (large ones) and takes unnessasary risks.

I was looking at alcoholism and found an article on how Excess dopamine leeds to addiction to alcohol and cigarettes, and then found all these symptoms listed in the same article associated with excess dopamine, this ties in with some of the movement controlling drugs in HD which are dopamine blockers which prevent the receptors in the brain from being effected by excess dopamine as it also effects movement.

I wonder therefore if anyone has seen dopamine blockers prescribed early in life to help alleviate these symptoms that would make Life for the sufferer and the carer a little easier.

Any feedback appreciated
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Old 21-09-18, 05:23 PM   #2
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Location: Hastings, East Sussex, UK
Posts: 1,152
Default Re: Any Research on HD and dopamine

Hi Saturn

I think I’d better delve straight in. My son, now 31, was diagnosed with a CAG repeat count of 56 six years ago. There is no family history whatsoever - except the discovery that I have a CAG of 35 and I’m, therefore, in the grey area.

For several years before diagnosis my son was easily angered, very aggressive, little or no empathy for others, lost all his friends, a heavy smoker of cigarettes and cannabis … and he had several other “antisocial” behaviours.

Your other listed “attributes” of addiction, competitive (in a negative way), spending sprees are well known in HD families. As for taking “unnecessary risks” I think I would see it as foolish or not thought out risks - a total lack of Insight (in HD terminology). These are some of the issues and symptoms that my son has:

a lack of spatial awareness; inability to organise or plan; poor personal hygiene; a complete lack of social awareness; inflexibility; lack of intuitive thought; lack of instinctive reaction; apathy or lack of initiative; agitation and anxiety; irritability; poor judgment; dysphoria; mild psychosis; mild paranoia; dis-inhibition. Strangely, he has a lack of focus and concentration (flitting from one activity to another in a few seconds) and obsessive-compulsive behaviour (staying engaged in computer games for hours on end).

It’s been seen that behavioural, emotional and psychiatric problems and issues early on in the first stage of HD can easily be mismanaged by incorrectly prescribed antipsychotic medication.

I’ve got no medical training but I’m a keen reader of everything related to HD, and whilst everyone’s racing for a cure, I’m just looking for everyday solutions to my son’s ongoing problems.

Dopamine is a signalling chemical (neurotransmitter) involved in movement control, mood and motivation. There are over 50 Dopamine blockers listed here:

I’ve come across Domperidone, Haloperidol, Metoclopramide, Olanzapine, Quetiapine, Risperidone and Sulpiride in relation to a variety of HD symptoms.

These antipsychotics seem to be the top option for reducing psychosis associated with movement disorder. Antipsychotics serve as a multi-purpose remedy for anxiety, weight loss, sleep dysfunction and irritability in conjunction with chorea.

Haloperidol: is useful in the treatment of cognitive disorders such as aggression, delusions, hallucinations and agitation.
Olanzapine: can be used to control movement disorders, anxiety, irritability, weight loss, depression and sleep dysfunction.
Quetiapine: is generally used to treat psychiatric symptoms. In a study, quetiapine was found to reduce irritability, agitation, and delusions without worsening motor symptoms in HD patients.
Risperidone: is proven to reduce abnormal movements and cause a general improvement in everyday activities. It is also used to treat anxiety, obsessive symptoms, depression, psychosis, and sleep dysfunction.

Unfortunately, most of the drugs required to treat symptoms of Huntington's Disease have moderate to severe adverse secondary effects. The following side effects have been implicated with the drugs mentioned:

Haloperidol: *Extrapyramidal symptoms, anticholinergic effects, weight gain.
Olanzapine: Sedation, weight gain, *extrapyramidal symptoms, postural hypotension, risk of metabolic syndrome.
Quetiapine: Somnolence, headache, agitation, hypotension, weight gain, dry mouth, increased triglycerides and cholesterol.
Risperidone: Increased appetite, *extrapyramidal symptoms, insomnia, vomiting, headache, coughing, constipation, postural hypotension.

*extrapyramidal symptoms include acute dyskinesias and dystonic reactions, tardive dyskinesia, Parkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome.

So, be very, very careful.

My son is now displaying minimal emotional and behavioural issues, although this isn’t due to medication. His excellent 24/7 Care team (and their pets) ensure that his only HD medication (Clonazepam) is only needed at a very minimal dose.

With the scientific research I usually read the introduction, then just scan the article - before reading the conclusions. This is all I could find that is readable:

Dopamine and Huntington’s disease (page 9)

The Role of Dopamine in Huntington’s Disease (page 9)

Dopamine imbalance in Huntington’s disease: a mechanism for the lack of behavioral flexibility

Unraveling a role for dopamine in Huntington’s disease: The dual role of reactive oxygen species and D2 receptor stimulation

Huntington’s disease

Best wishes

New Day; New Outlook; New Challenges; New Possibilities; New Outcomes; New Successes
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Old 14-10-18, 08:40 AM   #3
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Default Re: Any Research on HD and dopamine

Thank you, I know every patient exhibits in different ways, but I am told what happens in the parent and siblings is ussually similar, it is so easy with these types of symptoms to put them down to apathy or anger or depression as these we know about the reason for asking was that if it was a chemical imbalance due to the genes there is not the ussual things you can do about it having tried for 19 years on my own to work on the individual systems and not getting anywhere by ussual means it was very difficult! knowing that there could and I mean could be a root cause based on chemistry and the gene does not exclude trying but at least allows me to be realistic about the chance of success and look for little wins in other ways.

Alaways living with Hope
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