Systematic review of pharmacological treatments for depressive symptoms in Huntington's disease.

BACKGROUND: Depressive symptoms are common in Huntington's disease (HD), profoundly affect quality of life, and predict suicidal ideation. However, no recent review of antidepressant treatment in HD has been published. METHODS: We performed a PRISMA systematic review of HD studies, which used a recognized antidepressant and measured change in depressive symptoms using a validated psychiatric scale. Controlled trials, uncontrolled trials, observational studies, and case series were included. RESULTS: Eleven studies were included, totalling 190 patients. One study examined venlafaxine, one fluoxetine, one citalopram, one atomoxetine, one modafinil, one lithium, and five antipsychotics. No studies were of adequate duration, size, or outcome, and no controlled trial in a depressed population produced a positive result. CONCLUSIONS: Inadequate evidence exists to guide antidepressant treatment in HD. Further research is needed to assess antidepressant efficacy and to examine whether treatment of depression represents a modifiable target for the high suicide rate in HD.