Frontotemporal Dementia Treatments: What Helps Now and What’s Coming Next

When someone is diagnosed with frontotemporal dementia (FTD), the symptoms can look less like memory loss and more like a sudden shift in who that person seems to be. FTD affects the frontal and temporal lobes of the brain, leading to changes in behavior, language, and movement.

Despite the overlap in symptoms with Alzheimer’s, Parkinson’s, and various psychiatric conditions, the drugs that treat those conditions often don’t work for FTD. That doesn’t mean there’s no help available. Non-drug interventions are the frontline approach to treating the condition and help manage symptoms, increase independence, and improve quality of life. 

FTD is a rare group of neurodegenerative disorders, affecting an estimated 50,000 to 60,000 people in the U.S. Several promising drug candidates are currently in the pipeline, targeting both genetic and non-genetic forms of FTD across its many subtypes. Here’s what to know about FTD treatments available now — and what’s on the horizon.

Treatments for frontotemporal dementia

The first-line treatments for FTD right now are non-drug interventions. When those aren’t enough, doctors can prescribe other medications off-label to help manage the symptoms. But these drugs aren’t as well-studied in FTD and come with various downsides.

Non-drug interventions for FTD

Several supportive therapies could help enhance quality of life and safety for people experiencing symptoms of FTD:

• Occupational therapy helps individuals and caregivers adapt to their symptoms and maximize independence.
• Environmental modifications create a quiet, calm, safe environment that could ease agitation and reduce the risk of falls.
• Physiotherapy could help people with movement related forms of FTD manage their symptoms.
• Speech therapy for primary progressive aphasia. 
• Communication strategies reduce frustration and agitation between individuals and family members.

While research is still limited, some studies suggest that lifestyle changes may help with symptoms in the early stages of FTD. This includes:

• Regular exercise to support mobility and brain health
• Cognitive activities like reading, puzzles, or games to keep the mind active
• Healthy eating patterns such as the Mediterranean or DASH diet

Treating FTD’s mood and behavioral symptoms

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant drugs that might help with apathy, depression, agitation, anxiety, and compulsive behaviors in FTD and are generally considered safe. 

If these don’t work, some doctors might consider antipsychotic medications or benzodiazepines — however they aren’t recommended for older patients and may lead to side effects like worsening symptoms, confusion or falls. 

Alzheimer’s medications don’t work for FTD

Cholinesterase inhibitors approved for Alzheimer’s — including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne) — do not work well for FTD and come with a risk of side effects. 

Similarly, the Alzheimer’s drug memantine (Namenda) is not shown to work for FTD either, and may actually worsen cognitive symptoms. 

Treating FTD’s movement related symptoms

Two forms of FTD might lead to tremors, rigidity, and slowness of movement similar to Parkinson’s. Both progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are linked to an abnormal buildup of tau proteins in parts of the brain that control involuntary movements. In PSP, balance and eye movement are more affected while CBD affects the body’s limbs.However, carbidopa/levadopa which is used to treat those symptoms in Parkinson’s disease does not work well in FTD.

Experimental treatments for frontotemporal dementia

Researchers are testing new drugs that could eventually become the first approved treatments for FTD. 

Treatments for genetic forms of FTD

As many as 10 to 20 percent of FTD cases are caused by a mutation in a single gene. The mutated gene, which normally encodes the instructions for building a protein, interferes with normal brain function leading to neurodegeneration and dementia. 

Many companies are developing treatments for people with a mutation in the GRN gene. This mutation leads to low levels of an important protein called progranulin, and these low levels are thought to cause the neurodegeneration. These treatments bind to various proteins in the brain to increase the levels of progranulin. 

Treatments for people with the GRN mutation include:

• AL001, also called latozinemab (Denali Therapeutics & Takeda Pharmaceuticals): This monoclonal antibody drug is currently being tested in Phase 3 trials.
• PBFT02 (PassageBio): This is a form of gene therapy that involves delivering a functional version of the GRN gene into the brain. It is currently in early stage clinical trials.
• VES001 (VesperBio): This experimental pill in early stage trials aims to treat FTD by increasing progranulin levels.
• Several other drugs are in the early stages of development.

Other researchers are aiming to treat people with a mutation in the TDP gene that leads to a buildup of toxic TDP-43 proteins. Scientists at the University of California, San Francisco are conducting a Phase 2 trial of a pill called verdiperstat that targets inflammation in the brain of people with the semantic variant of primary progressive aphasia who have this mutation.

Trials for other forms of FTD and symptom management

Several other drug candidates are in late-stage trials:

• Oxytocin: The “love hormone” is being investigated as a possible treatment for apathy, a common symptom for people who have the behavioral variant FTD. A recent Phase 2 study found a small benefit, suggesting it could help. 
• NS101 (Neuracle Science): This monoclonal antibody binds to a protein called FAM19A5, helping brain cells stay healthy and connected. The drug is being tested in a small Phase 2 trial for treating people with semantic variant primary progressive aphasia.
• Vortioxetine: The drug, which is approved for treating anxiety and depression, is being tested in a Phase 2 trial to see if it could treat some of the mood and cognitive symptoms in bvFTD.
• Neflamapimod (CervoMed): The anti-inflammatory drug is being tested to treat the primary progressive aphasia in Phase 2 trials. 
• AADVac1 (Axon Neuroscience SE): This tau vaccine is being tested in a Phase 2 trial of progressive supranuclear palsy.

How to manage symptoms of frontotemporal dementia

For now, the most effective ways to manage FTD symptoms are non-drug interventions that don’t slow down the disease. But scientists and drugmakers are testing different drugs including vaccines, monoclonal antibodies, and experimental pills to see if they could help. 

If you or a loved one has been diagnosed with FTD, it’s important to talk with a specialist who understands the disease and can tailor treatment to your specific symptoms and stage of progression.

Frequently asked questions about frontotemporal dementia treatments

What is FTD?

Frontotemporal dementia (FTD) is a group of rare neurodegenerative diseases affecting 50,000 to 60,000 people in the U.S., accounting for 10 to 20 percent of total dementia cases. FTD may affect personality, behavior, speech, or movement abilities. There are currently no FDA-approved treatments that can slow or stop FTD, but doctors can manage symptoms with lifestyle changes, supportive care, and in some cases, certain medications.

What are the stages of frontotemporal dementia?

FTD typically progresses through early, middle, and late stages. Depending on the form of FTD, early symptoms might include changes in personality or behavior, speech difficulties, or movement-related symptoms. As the disease progresses, these changes become more pronounced and disruptive to daily life. In the late stage of the disease, people start to develop cognitive and physical problems and require around-the-clock care.

What medications are used to treat frontotemporal dementia symptoms?

Selective serotonin reuptake inhibitors may be prescribed to treat mood-related symptoms if other lifestyle changes or non-drug interventions don’t work. Other classes of medications that treat mood, cognitive, and motor symptoms might lead to more side effects or aren’t shown to be effective for FTD. 

Are there lifestyle changes that help with FTD?

Yes. While more research is needed, evidence suggests that exercise, cognitive activities like puzzles and reading, and healthy eating patterns such as the Mediterranean or DASH diet may support brain health and help manage early symptoms.

What new treatments for frontotemporal dementia are being studied?

Several experimental drugs are in clinical trials, including:

• AL001, also called latozinemab (Denali Therapeutics & Takeda Pharmaceuticals): This monoclonal antibody drug is currently being tested in Phase 3 trials.
• PBFT02 (PassageBio): This is a form of gene therapy that involves delivering a functional version of the GRN gene into the brain. It is currently in early stage clinical trials.
• VES001 (VesperBio): This experimental pill in early stage trials aims to treat FTD by increasing progranulin levels.
• NS101 (Neuracle Science): This monoclonal antibody binds to a protein called FAM19A5, helping brain cells stay healthy and connected. The drug is being tested in a small Phase 2 trial for treating people with semantic variant primary progressive aphasia.
• Vortioxetine: The drug, which is approved for treating anxiety and depression, is being tested in a Phase 2 trial to see if it could treat some of the mood and cognitive symptoms in bvFTD.
• Neflamapimod (CervoMed): The anti-inflammatory drug is being tested to treat the primary progressive aphasia in Phase 2 trials. 
• AADVac1 (Axon Neuroscience SE): This tau vaccine is being tested in a Phase 2 trial of progressive supranuclear palsy.

While none are yet approved, researchers are optimistic that the first disease-modifying treatment for specific types of frontotemporal dementia could be on the horizon.