Treatment of Huntington's Disease with Irritability — Impatience and Anger on Minimal Provocation

Irritability is a very common symptom in Huntington's disease. It is fluctuating in nature, characterised by impatience and a tendency to become angry in response to minimal provocation — a pattern that can significantly affect patients and those around them.

Clinical Scenario

This protocol addresses the management of irritability in Huntington's disease — specifically the presentation of impatience and a tendency to become angry in response to minimal provocation. The fluctuating character of this symptom, and the presence or absence of overt aggressive behavior, informs the choice of treatment approach.

Treatment Approach (partial)

First-line pharmacological management centres on a class of antidepressants; however, the specific agent and strategy depend on the precise clinical picture — particularly whether aggressive behavior is a prominent feature.

The complete regimen, including agent selection, dosing guidance, and sequencing, is available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.3389/fneur.2019.00710

Irritability is a very common symptom in HD.

This disorder is of fluctuating nature, characterized by impatience and a tendency to become angry in response to minimal provocation.

Whilst SSRIs are first lines for irritability (Grade C), it may be necessary to use them at or near the maximum recommended dose in order to be effective.

In patients with aggressive behavior, the recommended first-line treatment is a neuroleptic (Grade C).

In case of overt aggression associated with depression, neuroleptic treatment should be associated with sedative antidepressants.

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