F077 Pharmacological treatment of irritability in Huntington’s disease: a longitudinal cohort study

<h3>Background</h3> Neuropsychiatric symptoms (NPS) occur in nearly all Huntington’s Disease (HD) patients during the disease course. Irritability is a common NPS and is often the first sign of the disease. <h3>Aims</h3> To provide an overview of pharmacological treatments used for irritability, agitation and aggression in HD and their effects on irritability as assessed by the Problem Behavior Assessment – shortform (PBA-s) irritability subscale. <h3>Methods</h3> We conducted an analysis in a large database of HD patients, Enroll-HD on the treatment of irritability, agitation and aggressive behaviour. The number of prescriptions per medication class and treatment effect on the PBA-s irritability subscale were reported. <h3>Results</h3> Of the 25550 patients in Enroll-HD, 2292 (9.0%) used medication for irritability, agitation or aggressive behaviour. Antipsychotics were most frequently prescribed (4004 prescriptions, 52,0%), followed by antidepressants (1459 prescriptions, 18.9%). For all indications, antipsychotics were the most frequenly prescribed drugs. Antidepressants were more frequently prescribed for irritability (25.4% of all prescriptions compared to 5.5% and 5.9% for agitation and aggression, respectively), anxiolytics for agitation (38.5% of all prescriptions compared to 9.9% and 5.2% for irritability and aggression, respectively) and antipsychotics for aggression (77.0% of all prescriptions compared to 49.9% and 48.1% for irritability and agitation, respectively). One year of treatment with antidepressants and antipsychotics resulted in significant improvement on the PBA-s irritability subscale (reduction from 7.26 to 5.05 and 8.16 to 5.13, respectively). <h3>Conclusions</h3> Antipsychotics and antidepressants are the most commonly prescribed medications for irritability, agitation and agression and significantly reduce irritability as assessed by the PBA-s.