Management of psychiatric features in frontotemporal dementia

Frontotemporal dementia (FTD) refers to a group of neurodegenerative disorders that affects the frontotemporal cortices, resulting in progressive decline affecting cognitive and behavioral function. FTD is most commonly divided into three clinical syndromes: behavioral variant frontotemporal dementia (bvFTD) and two language variants, semantic variant primary progressive aphasia and nonfluent/ agrammatic variant primary progressive aphasia. bvFTD may present with symptoms that overlap with psychiatric disorders. Treatment in FTD is symptomatic rather than disease-modifying, consisting of both nonpharmacological behavioral interventions as well as pharmacological treatments such as selective serotonin reuptake inhibitors and neuroleptics. This review discusses a diagnostic approach to FTD followed by a review of the literature on both pharmacological and nonpharmacological interventions for the commonly observed psychiatric symptoms in this patient population.