Antisense oligonucleotides targeting mutant huntingtin under investigation
Gene silencing approaches in clinical trials
No currently approved disease-modifying therapy
Enroll-HD observational registry informing natural history and biomarker data
Patient Discharge Instructions
copy discharge instructions
Huntington's disease acute presentation home care instructions
Take all prescribed medications exactly as directed
Do not stop any medications without speaking to your neurologist or doctor first
Abruptly stopping chorea medications or antipsychotics can cause serious problems
Eating and drinking safety
Only eat foods and liquids approved by your swallowing assessment
Sit fully upright during all meals and for at least 30 minutes after
Take small bites and sips; do not rush eating
Have a caregiver or family member present during meals if possible
Call your doctor before resuming any foods you were told to avoid
Fall prevention
Remove loose rugs and clutter from floors
Use grab bars in bathroom and shower
Wear non-slip footwear at home
Do not walk alone if you have been falling frequently
Mental health
If you are having thoughts of hurting yourself, call 988 (Suicide and Crisis Lifeline) or go to the nearest emergency department immediately
Continue all prescribed antidepressants and psychiatric medications
Tell your care team about any mood changes, thoughts of self-harm, or unusual behaviors
Warning signs to return to the emergency department
Thoughts of suicide or self-harm
Fever above 38.5 C (101.3 F)
New or worsening confusion or agitation
Trouble breathing or fast breathing at rest
Difficulty swallowing or choking episodes
Inability to eat or drink for more than 24 hours
Muscle stiffness with fever (possible NMS)
Falls with head injury or loss of consciousness
Urine that appears brown or red (possible rhabdomyolysis)
New weakness on one side or sudden speech change (possible stroke or bleed)
Follow-up appointments
Neurologist within 1 to 2 weeks
Psychiatrist or mental health provider within 1 week if psychiatric concerns
Family doctor within 3 to 5 days
Speech and swallowing therapist if arranged
Resources
Huntington's Disease Society of America (HDSA) at hdsa.org for support, resources, and specialist centers
HD Buzz (hdbuzz.net) for patient-friendly research updates
Social work referral for caregiver support and community resources
References
Guidelines and key sources
Clinical guidelines
Armstrong MJ, Miyasaki JM. AAN Evidence-Based Guideline: Pharmacologic Treatment of Chorea in Huntington Disease. Neurology. 2012
Nazarian DJ et al. ACEP Clinical Policy: Critical Issues in Diagnosis and Management of Adult Psychiatric Patient in the ED. Annals of Emergency Medicine. 2017
Caron NS, Wright GEB, Hayden MR. Huntington Disease. GeneReviews. 2020
Key references
Roos RA. Huntington's Disease: A Clinical Review. Orphanet Journal of Rare Diseases. 2010
Ross CA, Tabrizi SJ. Huntington's Disease: From Molecular Pathogenesis to Clinical Treatment. Lancet Neurology. 2011
Walker FO. Huntington's Disease. Lancet. 2007
Massey TH, McLauchlan DJ. Huntington's Disease: A Clinical Primer for Acute and General Physicians. Clinical Medicine. 2024
Psychiatric and suicidality evidence
Kachian ZR et al. Suicidal Ideation and Behavior in HD: Systematic Review and Recommendations. Journal of Affective Disorders. 2019
Grimaldi A et al. Risk Factors and Interventions for Suicide in HD: Systematic Review. Journal of Clinical Medicine. 2024
van Duijn E et al. Suicidal Ideation and Behavior per C-SSRS in HD Gene Expansion Carriers. Journal of Affective Disorders. 2018
Stone F et al. Disentangling Suicidal Ideation from Behaviour in HD. General Hospital Psychiatry. 2026
Shiino S et al. Characterization of Psychiatric Admissions in HD: Retrospective Review. Journal of Psychosomatic Research. 2025
VMAT2 inhibitor evidence
Baghaei A et al. Safety and Efficacy of VMAT2 Inhibitors in Huntington Disease: Systematic Review. Parkinsonism and Related Disorders. 2026
Youssov K et al. Comparison of Tetrabenazine, Tiapride and Olanzapine in HD: Neuro-HD Trial. Parkinsonism and Related Disorders. 2025
Rosenthal LS et al. Vesicular Monoamine Transport Inhibitors: Current Uses and Future Directions. Lancet. 2025
Dysphagia and nutrition evidence
Schindler A et al. FEES in Early-to-Advanced Stage HD. Scientific Reports. 2020
Pizzorni N et al. Management of Dysphagia in HD: Descriptive Review. Neurological Sciences. 2020
Kalkers K et al. Dysphagia, Fear of Choking, Preventive Measures in HD. Journal of Nutrition Health and Aging. 2022
Pizzorni N et al. Predictors of Malnutrition Risk in Neurodegenerative Diseases. European Journal of Neurology. 2022
Hospitalization and epidemiology
Dubinsky RM. No Going Home for Hospitalized HD Patients. Movement Disorders. 2005
Rocha NP et al. Clinical Correlates of Depression and Suicidality in HD: Enroll-HD Analysis. Cognitive and Behavioral Neurology. 2022
Agitation management in ED
Klein LR et al. Intramuscular Midazolam, Olanzapine, Ziprasidone, or Haloperidol for Acute Agitation in ED. Annals of Emergency Medicine. 2018
ICD-10 coding
ICD-10 G10 Huntington disease
ICD-10 G21.0 Malignant neuroleptic syndrome
ICD-10 J69.0 Pneumonitis due to inhalation of food and vomit
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.