University of Oulu

Katisko, Kasper et al. ‘Psychopharmacological Medication Use in Frontotemporal Dementia at the Time of Diagnosis: Comparison with Alzheimer’s Disease’. 1 Jan. 2023 : 677 – 685.

Psychopharmacological medication use in frontotemporal dementia at the time of diagnosis : comparison with Alzheimer’s disease

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Author: Katisko, Kasper1; Krüger, Johanna2,3; Soppela, Helmi1;
Organizations: 1Institute of Clinical Medicine – Neurology, University of Eastern Finland, Kuopio, Finland
2Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
3MRC, Oulu University Hospital, Oulu, Finland
4Neuro Center – Neurology, Kuopio University Hospital, Kuopio, Finland
5A.I. Virtanen Institute for Molecular Sciences – University of Eastern Finland, Kuopio, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: IOS Press, 2023
Publish Date: 2023-10-05


Background: Due to the significant presence of neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) spectrum disorders, psychiatric misdiagnoses, diagnostic delay, and use of psychiatric treatments are common prior to the FTD diagnosis. Furthermore, treatment of diagnosed FTD patients mainly relies on off-label psychopharmacological approaches. Currently, limited real-world data are available regarding the actual use of psychopharmacological medications in FTD.

Objective: To evaluate psychopharmacological medication use at the time of FTD diagnosis.

Methods: Psychopharmacological medication use was evaluated in a Finnish FTD cohort containing 222 FTD patients, including the major clinical disease phenotypes (behavioral, language, and motor variants) and genetic patients carrying the C9orf72 repeat expansion. A cohort of 214 Alzheimer’s disease (AD) patients was used as a neurodegenerative disease reference group.

Results: Active use of psychopharmacological medications at the time of diagnosis was significantly more common in FTD compared to AD, especially in the case of antidepressants (26.1% versus 15.0%, OR = 2.01, p = 0.008), antipsychotics (23.9% versus 9.3%, OR = 3.15, p < 0.001), and mood-stabilizers (6.3% versus 1.9%, OR = 2.93, p = 0.085; not statistically significant), whereas the use of cholinesterase inhibitors or memantine was nearly nonexistent in FTD patients. Female gender and behavioral variant of FTD phenotype alongside with depressive and psychotic symptoms were the most prominent factors associating with the use of these medications among the FTD spectrum patients.

Conclusions: Use of off-label psychopharmacological medication and polypharmacy is substantially common at the time of FTD diagnosis. This likely reflects the challenges in using symptom-driven treatment approaches, especially prior to the eventual diagnosis.

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Series: Journal of Alzheimer's disease
ISSN: 1387-2877
ISSN-E: 1875-8908
ISSN-L: 1387-2877
Volume: 95
Issue: 2
Pages: 677 - 685
DOI: 10.3233/JAD-230494
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Copyright information: © 2023 IOS Press.