Psychopharmacological Treatments for Mental Disorders in Patients with Neuromuscular Diseases: A Scoping Review

Abstract

Mental disorders are observed in neuromuscular diseases, especially now that patients are living longer. Psychiatric symptoms may be severe and psychopharmacological treatments may be required. However, very little is known about pharmacotherapy in these conditions. We aimed to summarize the current knowledge on the use of psychopharmacological treatments for mental disorders in patients living with a neuromuscular disease. A scoping review was performed using the methodology of the Joanna Briggs Institute. Four databases were searched from January 2000 to July 2021. Articles were screened based on titles and abstracts. Full-text papers published in peer-reviewed journals in English were selected. Twenty-six articles met eligibility criteria, all being case reports/series focusing on the psychopharmacological control of psychiatric symptoms for the following conditions: myasthenia gravis (n = 11), Duchenne (n = 5) and Becker (n = 3) muscular dystrophy, mitochondrial disorders (n = 3), glycogen storage disease (n = 1), myotonic dystrophy (n = 1), hyperkalemic periodic paralysis (n = 1), and congenital myasthenic syndrome (n = 1). None of the articles provided details on the decision-making process to choose a specific drug/regimen or on follow-up strategies to monitor safety and efficacy. Larger studies showing real-world data would be required to guide consensus-based recommendations, thus improving current standards of care and, ultimately, the quality of life of patients and their families.

Cognitive and emotional disturbances in adult patients with myotonic dystrophy type 1

“…Таким образом, учитывая ограниченность в целом подходов к коррекции когнитивных нарушений, важным моментом ведения пациентов с МД1 становится необходимость проведения психотерапевтической работы для повышения мотивации, работоспособности, а также улучшения социальной коммуникации. Стоит помнить, что такие эмоциональные нарушения, как депрессия и тревога, могут быть отчасти скомпенсированы с помощью психофармакотерапии [29,30], для определения показаний к которой в рутинной практике могут использоваться специализированные тесты.…”

Adults living with Duchenne muscular dystrophy: old and new challenges in a cohort of 19 patients in their third to fifth decade

“…In our study, mental health specialists, including psychiatrists and psychologists, were involved in managing nearly half of the cohort, especially in cases where psychoactive medications were required to treat major symptoms such as obsessive‐compulsive behaviour and hallucinations. However, the lack of literature on the safety of psychoactive drugs in the DMD population often limits their use in such contexts [34]. Amongst our patients, only two were treated with low‐dose oral haloperidol, whilst the others experienced antidepressive/anxiolytic treatments, with constant monitoring of routine blood tests and QT interval and no major side effects.…”