Treatment of Frontotemporal Dementia with Depakote

Frontotemporal dementia can be a devastating disease, especially for family members watching their loved one have drastic swings in their behaviors, personality and ability to function on a day to day basis. Frontotemporal dementia is a specific type of dementia referring to a degeneration of the frontal and/or temporal lobe’s. In short, the frontal lobe controls out behavior, speech, impulse control and overall personality. Our temporal lobe is a language center crucial for understanding language. Deficits in one or both of these can lead to Frontotemporal dementia.

Whereas memory is often the major problem in other dementia subtypes, it is often the severe personality change, aggression and disinhibited behaviors that are most problematic in Frontotemporal dementia. While a key piece of treatment is working with families on how to understand and interact with their loved one, there is an important role for pharmacological treatment.

Traditional medications used for Alzheimer’s such as Aricept (a Cholinesterase inhibitor) or Memantine (an NMDA receptor antagonist) can slow progression of the disease to some extent, they can actually cause worsening of symptoms in Frontotemporal dementia. As a psychiatrist who specializes in geriatric psychiatric and dementia, I have had experience in multiple approaches to controlling problematic symptoms of Frontotemporal dementia and have found great success with Depakote.

Depakote (Valproic acid) is traditionally a anti-convulsive medication used in seizure disorders. In essence it slows down the firing of neurons which in the case of Frontotemporal dementia, helps to slow down disinhibited neuronal tracks of the brain that are not being properly buffered due to neuronal degeneration. Unlike antipsychotic medications (Haldol, zyprexa, Seroquel), Depakote does not cause nearly as many problematic side-effects. Antipsychotics also do not tend to be effective in controlling the problematic symptoms of Frontotemporal dementia yet they are frequently utilized.

Dosing Depakote 2 to 3 times daily in the ER form has provided the best results from the perspective of behavioral control which helps the patient remain more calm and in control of emotions. This minimizes their mental anguish and increases their quality of life in addition to the family’s qualities of life who can now have healthier interactions with their loved one.