Symptoms and Treatments for Huntington's Disease
What is Huntington's Disease?
Huntington’s Disease is a disorder that causes involuntary jerking movements (chorea) and changes in thinking, behaviour, and mood. It’s a hereditary condition that affects people of middle age or older. It’s also a progressive disease that gets worse over time. People with the most common form of Huntington’s disease, adult-onset, start having signs and symptoms in their thirties or forties.
They may notice clumsiness, trouble with complex tasks, and changing emotions. Eventually, they develop involuntary jerking movements and have difficulty walking and speaking. They can also lose their balance and have problems with swallowing, leading to weight loss and a risk of choking. This type of the disease can also cause dementia and psychiatric changes, including depression and anxiety.
Huntington disease is caused by an inherited difference in a gene called huntingtin (HTT). The normal version of this gene has three letters in a row: cytosine, adenine, and guanine (CAG), which code for the protein huntingtin. People with the defective gene have a longer CAG repeat than others and make a bigger form of this protein, which starts damaging brain cells.
The number of CAG repeats predicts how fast the disease will progress. If a person has 36 or more repeats, they will likely develop Huntington’s disease; less than that and they might not.
There’s no cure for Huntington’s disease, but medications can help with some of the symptoms. The drugs tetrabenazine (Xenazine) and deutetrabenazine (Austedo) have been approved by the FDA to control the involuntary writhing movements that occur with Huntington’s disease.
But these drugs can have side effects, like drowsiness and restlessness, and they don’t slow the progression of the disease.
In addition certain cannabis strains have proved to be effective in managing quality of life and reducing pain and anxiety symptoms.
Cannabinoids are known to be neuroprotective, anti-inflammatory and have a number of other properties. Cannabinoids’ potential therapeutic role is based on, among other qualities: their ability to reduce oxidative damage and excitotoxicity; control calcium influx; and limit the toxic effects of reactive microglia.(2)
The Stages of Huntington's Disease
The stages of Huntington’s disease vary widely from person to person and depend on the length of your CAG repeats. In general, people with fewer CAG repeats will not develop the disease and will not pass it on to future generations.
The preclinical or prodromal stage of Huntington disease starts between 20 and 30 years before the first physical symptoms appear. During this time, people begin to notice that they are not thinking as clearly and have trouble with everyday tasks like paying bills or doing chores. They may also have a hard time maintaining balance and may show signs of depression or irritability.
In stage II, the physical symptoms start to get worse. Involuntary movements that affect multiple areas of the body (chorea) are more severe and interfere with daily activities, such as work or family and qualify life. The progression of Huntington disease for people at this stage often finds that their relationships with friends and relatives become strained due to their inability to work or care for others.
During this stage, people have difficulty thinking through complex problems. They begin to have trouble eating and sleeping and are often unable to work or care for themselves. They might need to live in a nursing home or extended care facility to be safe and healthy.
People in this stage are aware that they have to do daily activities but require major assistance from others to carry out these tasks. They have a hard time swallowing and are very rigid, which can lead to serious injuries from falls. This stage usually lasts for up to 21 years from the onset of symptoms and Huntington disease death age.
Huntington's Disease Life Expectancy
The brain is the most important organ in our body and is responsible for many of our basic functions such as breathing, hunger, memory, movement, thinking, vision, touch and so much more. However, a hereditary disorder called Huntington’s Disease prevents the brain from functioning normally and leads to deterioration of the brain cells which eventually affects movement, cognition, and psychiatric symptoms.
This condition, known as HD, has no cure and the progression of Huntington’s disease usually results in death within 10-30 years of when symptoms first appear (1).
This genetic disorder affects the basal ganglia, a collection of nerve cells deep in the brain that coordinates movement (2). It is caused by the accumulation of abnormal proteins that lead to neurodegeneration (3). This abnormality primarily affects the caudate nucleus and the striatum of the brain.
Symptoms of Huntington’s disease include uncontrollable jerky movements of the face, arms, legs, trunk and vocal muscles (chorea), cognitive difficulties and psychiatric distress. It can also lead to loss of muscle coordination, balance, and mobility. The disease gradually worsens over time and eventually causes the patient to need full-time care (4).
Huntington’s Disease is a progressive condition that can cause loss of control over muscle groups. This results in uncontrollable, involuntary movement which is often referred to as chorea. This movement can range from jerking movements similar to those of MND to slow movement with rigidity (as in Parkinson’s Disease). Some patients may also exhibit tics that are comparable to those seen in Tourette syndrome.
The disease causes a gradual worsening of motor, cognitive and behaviour changes. It can also lead to incontinence, dementia and swallowing difficulties which put the patient at risk of choking and pneumonia. Symptoms of depression may also occur.
Although there is no cure for the disease, there are drugs for Huntington’s disease available that can help control and ease some of the symptoms (5). However, these drugs can have serious side effects and some may even make the symptoms worse. Medicinal Cannabis offers an alternative treatment that can alleviate some of the most difficult symptoms without the unwanted side effects.
Alcohol Dependence in Australia
Despite the widespread social acceptance of alcohol, there is a significant and growing burden of unhealthy drinking amongst Australians. Alcohol dependence is associated with 150,000 hospital admissions and 6,000 deaths each year and is one of the most common conditions seen in specialist treatment services.
- However, there is low uptake of evidence-based treatments including pharmacotherapies.
- Moreover, a number of at-risk groups are underserved by specialist alcohol and drug services.
- Using a community-based sample in urban and remote Aboriginal communities, this paper surveyed people about their drinking behaviours to identify patterns of harm and treatment-seeking.
Multivariate analyses showed that people who were dependent drinkers were eight times more likely to report harms and get help for their drinking than non-dependent drinkers. This group also had higher rates of comorbidity with mental health problems and lower rates of access to treatment services.
A wide range of interventions should be available for the management of unhealthy alcohol use, including screening (level A), counselling to promote moderation and abstinence, and brief motivational interviewing strategies for addressing problem drinking (level B). Screening tools that measure AUDIT criteria are recommended in general practice and hospitals, while direct measures of blood or breath alcohol concentrations can be useful in emergency departments. Level C interventions include comprehensive assessments in primary care and specialised consultations, and sustained abstinence is the best outcome for most (level D).
To deliver culturally responsive alcohol treatment, a holistic view of community is needed, which encapsulates two-way respectful collaboration, country, healing, self-determination and resilience to address alcohol-related harm.
Contact Us at CannaTelehealth to book an online doctors consultation to set up a treatment plan that reduces alcohols long term effects.
What is the Treatment and Management of Opioid Use Disorder?
The best treatments for OUD include behavioural therapy and medications. Medications can change brain chemistry to reduce cravings, relieve withdrawal symptoms and block the euphoric effects of opioids. Currently available medications include buprenorphine (Suboxone, Subutex) and methadone. Buprenorphine is the first medication to treat OUD that can be dispensed under a doctor’s prescription in office settings without additional training, making it more accessible than previous treatments. Naltrexone, an opioid antagonist that blocks the effects of other opioids, is also available as a monthly injection by clinicians with special training. Clinical trials have shown that these medicines are effective when combined with counselling. These combined treatments are called Medication Assisted Treatment or MAT.
Counselling can teach people with OUD new coping skills and help them identify the issues that contribute to drug abuse. Different types of psychotherapy can benefit people with OUD, including cognitive-behavioural therapy (CBT), contingency management and family-based therapy. Individuals with OUD may also find it useful to participate in peer support groups that help them share their struggles and provide encouragement that lessens the emotional effects of alcohol and opioid dependence.
Some hospitals offer residential treatment programs that combine housing with health care and addiction treatment services. These programs are highly structured and usually involve several kinds of counselling or behavioural therapies and medications. Some hospitals also have inpatient hospital-based programs for people with medical conditions who need to stay in the hospital for their health care needs.
How Can You Help?
When a friend or loved one is in recovery, your support is vital. You should encourage them to continue with their treatment and avoid making emotional appeals that could increase feelings of guilt or a sense of responsibility for using. Also, never try to “save” a person from their addiction. The best way to support someone in recovery is to attend meetings with them, and join mutual-aid groups such as Alcoholics Anonymous or Narcotics Anonymous.
Alcohol addiction treatment is sometimes funded under various programs through Medicare. Treatment of alcoholism is key to patients’ quality of life.
Frequently Asked Questions
Which Healthcare professional should I contact to support me through Huntington’s disease
In Australia, a number of organisations are available to help individuals and families dealing with the diagnosis and progression of Huntington’s disease. Each has their own approach to care but all aim to create a community network to help support patients and their loved ones. Some of these networks also offer education on the disease and offer professional guidance to care teams. We have listed all contact details in this article.
What is the Most Effective Treatment For Huntington's Disease?
Medications can help manage symptoms, as there is no known cure, but some of these medications have unwanted side effects. New research is underway to find better drugs for Huntington’s disease. Researchers use fruit flies and mice that are engineered to get Huntington’s disease so scientists can test drugs that can treat or prevent the symptoms before people with the disease develop them. If promising drug trials work in these models, they may later be tested in human volunteers.
Involuntary movements (chorea) in Huntington’s disease are caused by abnormalities in structures deep in the brain that regulate motor movement, especially in a region called the basal ganglia. These changes are often seen on MRI or CT scans. Other changes seen on brain imaging include shrinkage in certain parts of the brain and enlargement of fluid-filled cavities called ventricles.
Other signs of the disease include slurred speech, swallowing problems, and difficulty walking. Some people lose weight and have trouble with breathing, choking, and chest infections. Some patients have found taking Medicinal Cannabis can assist with personality changes. Eventually, they need to stay in bed or in a wheelchair. Some develop psychiatric problems, such as depression or violent outbursts. Others have a change in sense of time and place, called temporal disorientation, and can’t understand visual spatial relationships.
Families of people with Huntington’s disease can seek support from local or online support groups. They can also look into care services. These can range from home health aides to nursing homes.
Medical Cannabis Doctors Online Treatment and Consults
Cannabis is an alternative plant based therapies. It is one of the potential treatments to relieve the symptoms of Huntington’s Disease. It is not the only solution and should not be used in isolation to traditional treatments suggested by your doctors.
Should you wish to find out from an expert Medicinal Cannabis practitioner as a treatment option via telehealth from the comfort of your home then it is possible through CannaTelehealth.
All doctors are registered with AHPRA and are trained in Medicinal Cannabis prescribing as an Authorised Prescriber. They are registered across all states of Australia to conduct medical evaluations in the state in which they practise. You can rest assured that you’re meeting with a doctor who is experienced in medicinal cannabis evaluations and has the latest in telehealth technology.
Our online healthcare professionals will discuss your current medications and strains and provide an unbiased opinion on whether medical marijuana can assist you with your condition. It’s important to upload your medical records before the consultation, so the doctor has all of the information they need to make an informed decision. Our doctors will take the time to answer any questions or concerns you may have, so don’t hesitate to ask!
Many GPs experience requests from their regular patients for medical cannabis, however a significant proportion of doctors are reluctant to prescribe it. Largely due to a lack of education which is needed for doctors to better understand the beneficial and adverse effects of cannabis, as well as how it can best be prescribed.
What We Do
CannaTelehealth is a telehealth brand backed by the trusted and original Telehealth provider company Phenix Health. CannaTelehealth specialises in online consultations with the ability to help assist treatment of opioid dependence and alcohol addiction. Our platform is designed to enable medical professionals to use the latest telehealth technology, whilst keeping patient information secure and complying with privacy and security regulations.
We have been able to create an online system that makes it easy for patients to book appointments online with qualified and experienced Nurse Practitioners or Doctors, who can assist in the process of accessing Medicinal Cannabis for the treatment of their medical condition. Our telehealth system is fully backed by our clinical team who ensure that all consultations are conducted by suitably qualified health care professionals.
Our doctors are all able to apply for Medicinal Cannabis under the schedule 8 of the Therapeutic Goods Act (TGA), allowing them to prescribe the medication as required. During the initial consultation, your nurse or doctor will work with you to determine whether Medicinal Cannabis is appropriate for your specific symptoms and conditions. If it is, they will then apply for a TGA approval for your escript, which can be used by your pharmacy to order the product.
References:
- What Is the Life Expectancy of Someone With Huntington’s Disease? April 15, 2020
- Therapeutic potential of cannabinoids as neuroprotective agents for damaged cells conducing to movement disorders Int Rev Neurobiol. 2019;146:229-257. doi: 10.1016/bs.irn.2019.06.012. Epub 2019 Jun 28. Mario Antonazzo 1, María Botta 2, Harkaitz Bengoetxea 3, José Ángel Ruiz-Ortega 4, Teresa Morera-Herreras 5
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Disclaimer: CannaTelehealth is not promoting the use of medicinal cannabis. Medicinal cannabis does affect every person differently, due to factors such as size, weight, health, dosage, tolerance and age. Medicinal cannabis might not work for you, and you might experience side-effects. Information provided by CannaTelehealth is for educational and informational purposes only. For medical advice, please refer to your doctor. Medicinal cannabis in Australia is regulated by the Therapeutic Goods Administration and details about cannabis as a scheduled drug can be found on their website.
