Treatment of CADASIL
So far there is no cure for CADASIL, and there are no medications that reliably slow or prevent progression of the disease. Cures or treatments might become available in the future as more is learned about the mechanisms of CADASIL, but it is impossible to predict when this will happen.
Treating the Symptoms of CADASIL
Although there is no cure for CADASIL itself, many symptoms of the disease can be treated effectively. For example, migraine attacks and epileptic seizures can be treated with conventional migraine and anti-seizure drugs. Other forms of therapy, in addition to medication, should also be considered. Physical therapy, counseling, speech therapy, and occupational therapy often have a positive influence on symptoms of the disease. Depression and memory loss can also be treated with medications and therapy. These treatments should be prescribed by a trained neurologist or psychiatrist.
We still do not know whether CADASIL patients benefit from treatments such as aspirin, that are often used to help prevent stroke.. Your neurologist may recommend that you take a low-dose aspirin or a similar medication daily to try to prevent a stroke. Warfarin (coumadin) and TPA (to dissolve blood clots) should be avoided because they increase the risk of bleeding in the brain. Triptans to treat migraine should also be avoided because they increase the risk of stroke.
Taking Care of Your Health
Currently, there are limited medical interventions for controlling the natural progression of CADASIL. However, patients with the disease should make healthy lifestyle choices that reduce the risk of additional injury to the blood vessels. Such risk factors include high blood pressure, diabetes, high cholesterol, obesity, smoking, lack of physical exercise, and other controllable conditions. This means, for example, that smokers should stop smoking. Blood pressure, blood sugar levels and cholesterol levels should be monitored at regular intervals and treated if necessary. Exercise is also important.
The contraceptive pill is also a risk factor. Therefore, if possible, women should stop using the pill or, if necessary, switch to a preparation having a lower estrogen content (estrogen content less than 50 µg). In addition, subjects should ensure an adequate intake of fluids (2 to 3 liters of fluid per day, not counting coffee, tea or alcoholic beverages). This is especially true in hot weather.