Clinical pharmacology of comorbid obsessive-compulsive disorder in Tourette syndrome

Treatment of Tourette Syndrome (TS) and its comorbidities is symptomatic and directed to improve the patient's social functioning and quality of life, to reduce the impairment from comorbid disorders, and to control tics severity. Often the pharmacological treatment combined with the multidisciplinary treatment is intended for comorbid disorders rather than for the tics themselves. Obsessive-compulsive disorder (OCD) is one of the most common comorbid conditions. Even so, to our knowledge no clinical trials have specifically evaluated the treatment of OC symptoms in TS patients. After a brief introduction to the treatment of pure OCD, in this chapter we will inspect data and information mostly drawn from the small number of clinical trials on efficacy of antiobsessional drugs that have also included patients with tics and compared their clinical effects in OCD subjects with and without tics. SRI or SSRI treatment will be presented, together with alternative strategies and novel therapeutic approaches for poor or no response. Data on safety and tolerability will be reviewed.