Huntington's Disease with Irritability — Impatience and a Tendency to Become Angry in Response to Minimal Provocation

Irritability is a very common neuropsychiatric symptom in Huntington's disease. When present, it follows a fluctuating course — characterised by impatience and disproportionate anger triggered by minimal provocation — and warrants targeted clinical management.

Clinical Scenario

This protocol applies to patients with Huntington's disease who present with irritability: a fluctuating symptom characterised by impatience and a tendency to become angry in response to minimal provocation. This symptom pattern is distinct from general agitation and is common across the HD population.

Treatment Approach

The protocol addresses irritability through a pharmacological approach that may include combination therapy, with specific consideration for patients in whom sleep disturbances are also present.

The complete regimen — specific agents, sequencing, and decision criteria — is available in the full structured protocol below.

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.
Irritable patients who do not benefit from an SSRI alone may benefit from combination therapy with Mianserine or Mirtazapine, especially when sleep disorders are present.

View source ↗