This protocol addresses patients with Huntington's disease who exhibit perseveration — the repetition of a thought, behavior, or emotion beyond the psychological context in which it arose — or obsessive-compulsive phenomena. In Huntington's disease, such repetitive thoughts and behaviors can persist for hours, months, or even years after the original trigger, significantly affecting quality of life and daily function.
When pharmacological treatment is warranted for perseverative or obsessive-compulsive symptoms, the approach depends on the predominant symptom profile and associated features — including the presence of anxiety or irritability. A specific class of agents is considered as first-line in at least one of these presentations.
DOI: 10.3389/fneur.2019.00710
Perseveration may be defined as the repetition of a thought, behavior or emotion beyond the psychological context in which it arose, and in patients with HD these repetitive thoughts and behaviors can persist for hours, months, or even years after the original trigger.
If pharmacological treatment is necessary for perseverative symptoms, an SSRI could be prescribed (Grade C), in particular when symptoms are associated with anxiety.
Olanzapine and risperidone (Grade C) are two valuable therapeutics for ideational perseverations, in particular when they are associated with irritability.
If pharmacological treatment is necessary for obsessive-compulsive phenomena, a SSRI should be prescribed as first-line treatment (Grade C).
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