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Pick's disease - Treatment

Alternative Names

Semantic dementia; Dementia - semantic; Frontotemporal dementia; Arnold Pick's disease

Treatment:

There is no specific treatment for Pick's disease. Certain antidepressants may help manage mood swings related to Pick's disease, but further research is needed.

Sometimes patients with Pick's take the same medications used to treat other types of dementia, such as medications that decrease the breakdown of the chemical messenger, acetylcholine (anticholinesterase inhibitors), and memantine (Namenda).

In some cases, stopping or changing medications that worsen confusion or that are not essential can improve thinking and other cognitive functions. This may include medications such as:

It's important to treat any disorders that contribute to confusion. These may include:

Treating any medical and psychiatric disorders often helps improve mental function.

Medications may be needed to control aggressive, dangerous, or agitated behaviors.

Some patients may need hearing-aids, glasses, cataract surgery, or other treatments.

Behavior modification can help some people control unacceptable or dangerous behaviors. This consists of rewarding appropriate or positive behaviors and ignoring inappropriate behaviors (when it's safe to do so).

Formal psychotherapy treatment doesn't always work, because it can cause further confusion or disorientation.

Reality orientation, which reinforces environmental and other cues, may help reduce disorientation.

Depending on the symptoms and severity of the disease, the patient might need monitoring and help with personal hygiene and self-care. Eventually, there may be a need for 24-hour care and monitoring at home or in a special facility. Family counseling can help the person cope with the changes needed for home care.

Care may include:

  • Adult protective services
  • Community resources
  • Homemakers
  • Visiting nurses or aides
  • Volunteer services

People may need legal advice early in the course of the disorder. Advance directives, power of attorney, and other legal actions can make it easier to make ethical decisions regarding the care of the person with Pick's disease.

Support Groups:

Some communities may have support groups (such as the Alzheimer's - support group, elder care - support group, or others).

Expectations (prognosis):

The disorder quickly and steadily becomes worse. Patients become totally disabled early in the course of the disease.

Commonly, Pick's disease causes death within 2 - 10 years, usually from infection and sometimes from general failure of the body systems.

Complications:

  • Abuse by an over-stressed caregiver
  • Infection
  • Loss of ability to care for self or perform normal activities
  • Loss of ability to interact with others
  • Progressive loss of ability to function
  • Side effects of medications used to treat the disorder
  • Reduced life span

Calling your health care provider:

Call your health care provider if you develop symptoms of Pick's disease.

Call your health care provider or go to the emergency room if mental function gets worse (which may mean that another disorder has developed).

  • Reviewed last on: 2/6/2008
  • Daniel Kantor, MD, Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, MO: Mosby; 2004.

Pierce JM. Pick's disease. J Neurol Neurosurg Psychiatry. 2003 Feb;74(2):169.

Grossman M. Frontotemporal dementia: a review. J Intl Neuropsychol Soc. 2002;8:566-583.

Grossman M. Progressive aphasic syndromes: clinical and theoretical advances. Curr Opin Neurol. 2002;15:1-5.

McKhann G, Albert M, Grossman M, Miller B, Dickson D, Trojanowski J. Clinical and pathological diagnosis of frontotemporal dementia. Arch Neurology. 2001;58:1803-1809.

Goetz CG. Goetz: Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders; 2007.

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