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Drug Therapies for Tourette Syndrome-Related Tics Tested in Clinical Trials
ST. PAUL, MN -- Two recent clinical trials to evaluate the effectiveness of drugs in treating vocal and motor tics associated with Tourette syndrome are reported in the March 13 issue of Neurology, the scientific journal of the American Academy of Neurology.
Tourette syndrome is a chronic neuropsychiatric disorder characterized by involuntary and compulsive motor and verbal tics that wax and wane.
One study, conducted at the Johns Hopkins University School of Medicine in Baltimore, tested the effectiveness of the drug baclofen on 10 children ranging in age from 8 to 14, with Tourette syndrome. The crossover tests were conducted using both the drug and placebos.
All of the nine patients that completed the regimen showed improvement in total severity scores after taking baclofen, but researchers said that while the drug was effective in reducing anxiety and tension, reduction of the number of tics was not statistically significant. Patients simply felt better about their conditions, and parents reported an overall improvement in quality of life factors.
Study author Harvey S. Singer, MD, said "We found statistically significant evidence that baclofen improved overall symptoms of Tourette syndrome in the children over a 4-week period. In addition to tics, children with Tourette syndrome often have a variety of other problems including obsessive compulsive disorder, attention-deficit hyperactivity disorder, and other behavioral problems." He concluded that children with Tourette syndrome might benefit from treatment with baclofen, although the improvements may be related to factors other than tics. No major side effects were associated with baclofen.
Singer said additional trials that would include an assessment of neurobehavioral factors, including anxiety, depression, attention deficit and hyperactivity disorder, are warranted.
Another trial tested the effectiveness of botulinum toxin on 18 adult Tourette syndrome patients with tics. The reduction in the number of tics per minute was reduced an average of 39 percent versus a 6 percent increase in tics per minute among those taking placebos. Study author Anthony E. Lang, MD, a neurologist with Toronto Western Hospital in Toronto, Ontario, Canada, reported that treatment with botulinum also reduced the urge associated with the tic by 46 percent. Lang said half of the patients experienced a side effect of weakness of the injected muscle, several reported feeling physically weak, while two others reported feeling restless or "fidgety." Another two patients felt the inability to perform the treated tic resulted in the emergence of a new tic to replace it. Although there was a documented significant reduction in individual treated tics, unlike baclofen, there was no overall improvement in "global" Tourette severity scores reported with botulinum toxin.
Tourette syndrome and related tics are relatively common. A 1998 epidemiologic study indicted that about 3 percent of school age children show evidence of Tourette syndrome. Medications for tic suppression are usually reserved for patients whose tics are functionally disabling.
A neurologist is a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system.
The American Academy of Neurology, an association of more than 17,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.
For more information about the American Academy of Neurology, visit its Web site at www.aan.com. -end-
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