Tourette syndrome: successful treatment with clonidine and oxycodone

A 15-year-old boy with Tourette's syndrome exhibited severe involuntary self-mutilatory behavior. While clonidine effectively controlled the motor and phonic tics, it failed to ameliorate the self-mutilatory behavior. Administration of oxycodone (50 mg/day) combined with clonidine produced a dramatic reduction in the frequency and severity of the self-mutilatory acts within 12 h. This report indicates that disturbances in the functional interplay between the noradrenergic and opiatergic systems may be important in the pathophysiology of Tourette's syndrome.