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Tourette’s Syndrome and Role of Tetrabenazine

Review and Personal Experience

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Abstract

Gilles de la Tourette’s syndrome (Tourette’s syndrome; TS) is an inherited tic disorder commonly associated with other neurobehavioural conditions such as attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). While the clinical presentation of TS and other features of this disorder have been well characterized, the genetic and neurobiological basis of the disease remains incompletely elucidated. The suggestion of a central role of dopamine in the aetiology of TS has been made on the basis of experimental studies, evidence from neuroimaging studies and the therapeutic response patients with TS have to agents that antagonize or interfere with putative dopaminergic pathways. Tetrabenazine is such an agent; it depletes presynaptic dopamine and serotonin stores and blocks postsynaptic dopamine receptors. In clinical studies, tetrabenazine has been found to be effective in a wide range of hyperkinetic movement disorders, including small numbers (<50) of patients with TS in some studies. Results of a retrospective chart review enrolling only patients with TS (n = 77; mean age ≈15 years) showed that 2 years’ treatment with tetrabenazine resulted in an improvement in functioning and TS-related symptoms in over 80% of patients, findings that suggest that treatment with tetrabenazine may have long-term benefits. The authors’ experience with 120 heavily co-medicated patients with TS confirms these findings. Long-term (mean 19 months) tetrabenazine treatment resulted in a Clinical Global Impressions of Change scale rating of ‘improved’ in 76% of patients. Such findings are promising and suggest that tetrabenazine may be suitable as add-on therapy in patients for whom additional suppression of tics is required.

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Acknowledgements

Editorial support for this manuscript was provided by the Medical Communications Group, Wolters Kluwer Health, Pharma Solutions Division. Medical writers were involved in the initial literature search and drafting of materials prior to a review and redrafting by Prof. Porta. The medical writing of the review part of this article and not the personal experience section was funded by an educational grant from Chiesi Italia. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Tourette Clinic and Functional Neurosurgery, IRCCS Galeazzi Hospital, Via R. Galeazzi 4, Milan, Italy

    Mauro Porta, Marco Sassi, Mario Cavallazzi, Maurizio Fornari, Arianna Brambilla & Domenico Servello

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  1. Mauro Porta
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  2. Marco Sassi
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Correspondence to Mauro Porta.

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Porta, M., Sassi, M., Cavallazzi, M. et al. Tourette’s Syndrome and Role of Tetrabenazine. Clin. Drug Investig. 28, 443–459 (2008). https://doi.org/10.2165/00044011-200828070-00006

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