The essential first steps to treating someone with FTD are an accurate diagnosis and non-pharmacologic intervention. These steps should be followed by a review of all medications (prescribed, OTC, herbal, etc.) to look for contraindications, interactions, inappropriate prescription or inappropriate dosage. As of yet, there are no medications available to cure or delay the progression of FTD, but there are a number of medications that alleviate the symptoms. Medical management includes treatment of concomitant medical conditions such as infections, parkinsonian symptoms, seizures, pain and improving nutritional status. All medications the patient is taking should be fully reassessed for optimal response at the dose prescribed, and the patient should only be on necessary medications that are effective in treating the underlying conditions.

Of the reversible dementias, medication use is the most common cause. Furthermore, adverse drug events (ADEs) occur in 15 to 35% of older people, with 29% of those events requiring health care services. An inappropriate or contraindicated medication can cause greater harm than good to the patient due to impaired liver metabolism, decreased renal function, increased body fat or increased sensitivity to CNS medications which can produce impaired memory and delayed psychomotor performance. While each individual varies in their sensitivity and precise condition, these general guidelines should be considered before prescribing certain medications.

The UCSF Memory and Aging Center runs multiple observational and interventional studies in FTD. If your patient is interested, we welcome your referrals. Please have them contact us so we can review the study protocol and consent with them and see if they meet the study criteria.