Compulsive behaviors in patients with behavioral variant frontotemporal dementia (bvFTD) occur frequently and are challenging to manage. We report three cases of probable bvFTD associated with compulsive behaviors that responded well to treatment with clomipramine at daily dosages varying from 20 to 175 mg. The titration approach involved an initial 10-mg dose that was subsequently increased in 10 mg increments on a weekly basis until symptom relief without intolerable side effects. Our case series supports the consideration for a therapeutic trial with clomipramine in bvFTD when compulsive behavior occurs in these patients. It also highlights the need for further research on pharmacological treatments in bvFTD.
*Division of Genetics and Development, Toronto Western Research Institute
¶Division of Neurology, University Health Network
†Department of Medicine, Division of Neurology, University of Toronto
‡Lyndhurst Centre, Toronto Rehabilitation Institute
∥Division of Neurology, Mount Sinai Hospital, University of Toronto
§Division of Neurology, Sam & Ida Ross Memory Clinic, Rotman Research Institute, Baycrest, Toronto, ON, Canada
M.F. was supported in part by Saul A. Silverman Family Foundation Toronto, Canada, as a Canada International Scientific Exchange Program. J.C.F. was supported by Christopher and Dana Reeve Foundation as well as Javenthey Soobiah Scholarship, Nellie L. Farthing Fellowship, William S. Fenwick Fellowship, and Edward Christie Stevens Fellowship from the University of Toronto.
The authors declare no conflicts of interest.
Reprints: Julio C. Furlan, MD, MBA, MSc, PhD, Toronto Western Research Institute, 399 Bathurst Street, McL 12-407, Toronto, ON, Canada M5T 2S8 (e-mail: firstname.lastname@example.org).
Received February 13, 2012
Accepted May 26, 2012