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Tourette's Syndrome.

Donald L Gilbert1, Tara D Lipps

  • 1Cincinnati Children’s Hospital Medical Center, Division of Neurology, ML #2015, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. d.gilbert@cchmc.org.

Current Treatment Options in Neurology
|April 9, 2005
PubMed
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Tourette's syndrome, a neuropsychiatric disorder, requires treatment when tics cause impairment. Managing comorbid conditions like ADHD and OCD is key to effective symptom control.

Area of Science:

  • Neuropsychiatry
  • Pediatric Neurology
  • Clinical Psychology

Background:

  • Tourette's syndrome is a childhood-onset disorder featuring motor and vocal tics.
  • Frequently co-occurs with attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, and impulsivity.
  • Treatment is indicated for significant functional, social, or pain impairment, especially with self-injurious tics.

Purpose of the Study:

  • To outline treatment considerations for Tourette's syndrome.
  • To discuss management strategies for tics and comorbid conditions.
  • To review pharmacologic and non-pharmacologic interventions.

Main Methods:

  • Review of current treatment guidelines and evidence for Tourette's syndrome.
  • Discussion of pharmacologic options including alpha-2 adrenergic agonists, SSRIs, neuroleptics, and atypical antipsychotics.

Related Experiment Videos

  • Evaluation of non-pharmacologic interventions such as habit reversal treatment and deep brain stimulation.
  • Main Results:

    • Alpha-2 adrenergic agonists can reduce tics and improve ADHD symptoms.
    • ADHD treatment, including stimulants, generally does not worsen tics.
    • SSRIs may alleviate obsessive-compulsive and anxiety symptoms, indirectly reducing tics.
    • Neuroleptics and atypical antipsychotics are options for severe tics but carry risks of side effects.
    • Habit reversal treatment shows promise as a non-pharmacologic approach.
    • Deep brain stimulation is experimental but has shown benefit in severe adult cases.

    Conclusions:

    • Treatment of Tourette's syndrome should be individualized, prioritizing targets based on specific impairments and comorbid conditions.
    • A combination of pharmacologic and non-pharmacologic strategies may be necessary for optimal management.
    • Careful consideration of risks and benefits is essential when choosing interventions, particularly for severe or refractory cases.