Impulse control disorders in frontotemporal dementia: spectrum of symptoms and response to treatment

Gen Hosp Psychiatry. Nov-Dec 2014;36(6):760.e5-7. doi: 10.1016/j.genhosppsych.2014.06.005. Epub 2014 Jun 17.

Abstract

Objective: To describe a patient with behavioral variant frontotemporal dementia (bvFTD) presenting with impulse control disorders (ICDs) which responded to fluvoxamine and topiramate.

Case report: A 64-year-old woman was affected by several ICDs. At disease onset, she suffered from impulsive smoking and overeating which caused a body weight increase of 20 kg in 6 months. Later on she manifested binge-eating behavior and skin-picking compulsion. Presence of progressive frontal cognitive impairment (Mini Mental State Examination 24/30) and evidence of hypoperfusion of the anterior cingulate and dorsolateral frontal cortex with brain single-photon emission computed tomography scan contributed to the diagnosis of bvFTD. Use of combination treatment with selective serotonin reuptake inhibitor drugs and topiramate improved all these symptoms.

Conclusion: This case extends the clinical phenotype of repetitive and compulsive habits in bvFTD to encompass symptoms suggestive of ICDs. It is proposed that fluvoxamine and topiramate may be considered as treatment options in these conditions.

Keywords: Binge-eating disorder; Compulsion; Frontotemporal dementia; Impulse control disorder; Topiramate.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticonvulsants / administration & dosage
  • Anticonvulsants / pharmacology*
  • Disruptive, Impulse Control, and Conduct Disorders / drug therapy*
  • Disruptive, Impulse Control, and Conduct Disorders / etiology
  • Disruptive, Impulse Control, and Conduct Disorders / physiopathology
  • Drug Synergism
  • Female
  • Fluvoxamine / administration & dosage
  • Fluvoxamine / pharmacology*
  • Frontotemporal Dementia / complications
  • Frontotemporal Dementia / drug therapy*
  • Frontotemporal Dementia / physiopathology
  • Fructose / administration & dosage
  • Fructose / analogs & derivatives*
  • Fructose / pharmacology
  • Humans
  • Middle Aged
  • Serotonin Uptake Inhibitors / administration & dosage
  • Serotonin Uptake Inhibitors / pharmacology*
  • Topiramate
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Serotonin Uptake Inhibitors
  • Topiramate
  • Fructose
  • Fluvoxamine