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Drugs

, Volume 61, Issue 15, pp 2207–2220 | Cite as

Pharmacological Options for the Treatment of Tourette’s Disorder

  • Félix Javier Jiménez-Jiménez
  • Pedro José García-Ruiz
Therapy in Practice

Abstract

Tourette’s disorder is a neuropsychiatric disorder characterised clinically by motor and vocal tics, which may be associated to conductual disorders such as obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD). Although the neurochemistry of Tourette’s disorder is not well known, there are some effective therapies for tics, OCD and ADHD. However, these are not devoid of adverse effects.

Tics only require treatment when they interfere with the functioning of the patient. If therapy is needed, monotherapy at the minimal effective dose is desirable, but some patients may require two or more drugs. The most frequently used drugs for tics are antipsychotics (mainly pimozide and haloperidol) and clonidine. The potential usefulness of atypical antipsychotic drugs (risperidone, olanzapine, clozapine, ziprasidone) and other dopaminergic drugs (fluphenazine, sulpiride, tiapride, metoclopramide, piquindone, tetrabenazine), clonazepam, calcium channel antagonists, botulinum toxin, dopamine agonists, selegiline, and other drugs is discussed.

The drugs of choice for OCD in patients with Tourette’s disorder are the selective serotonin reuptake inhibitors (SSRIs), although the tricyclic antidepressant clomiplamine, which inhibits both serotonin and noradrenaline uptake, has also been found to be useful.

ADHD can be treated with some psychostimulants, mainly methylphenidate, although these drugs must be used with caution. Other potentially useful drugs for the treatment of ADHD in patients with Tourette’s disorder are clonidine, guanfacine, selegiline, some tricyclic antidepressants, sertraline, pimozide and clonazepam.

Finally, the potential value of some nonpharmacological therapies (hypnotherapy, biofeedback, conductual therapies, electroconvulsive therapy, acupuncture and surgery) is briefly reviewed.

Keywords

Haloperidol Clonidine Botulinum Toxin Naltrexone Clonazepam 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Adis International Limited 2001

Authors and Affiliations

  • Félix Javier Jiménez-Jiménez
    • 1
  • Pedro José García-Ruiz
    • 2
  1. 1.Department of Medicine - Neurology, Hospital ‘Príncipe de Asturias’Universidad de Alcalá, Alcalá de Henares (Madrid), and Neuro-Magister S.L. CompanyMadridSpain
  2. 2.Service of NeurologyFundación Jiménez DíazMadridSpain

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