YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==TOURETTE'S SYNDROME - RISPERIDONE== 1 AUTHOR Bruun RD AUTHOR Budman CL TITLE Risperidone as a treatment for Tourette's syndrome. SOURCE J Clin Psychiatry; VOL 57, ISS 1, 1996, P29-31 ABSTRACT BACKGROUND: An open-label trial was performed to assess the efficacy and safety of risperidone, a benzisoxazole derivative with potent D2 and 5-HT2 antagonism, for treatment of Tourette's syndrome. METHOD: Thirty-eight patients with Tourette's syndrome volunteered to take risperidone for treatment of their tics. All patients had failed to respond adequately to conventional treatments (with neuroleptics such as haloperidol and/or with the alpha 2-adrenergic agonist clonidine) or had suffered from intolerable side effects from such treatments. Patients were rated for tic severity by the Yale Global Tic Severity Scale (YGTSS) before treatment and after 1 month of treatment with risperidone. Patients were monitored carefully for side effects and clinical response. RESULTS: Of the 38 patients, 8 discontinued risperidone treatment before the end of the trial because of intolerable side effects. At the end of the 4-week trial, 22 patients (58%) were improved, 7 patients (18%) had no appreciable change in their symptoms, and 1 patient (3%) had a documented worsening of tics. Doses of risperidone at the end of the trial ranged from 0.5 mg to 9 mg/day (mean = 2.7 mg/day). CONCLUSION: This open clinical trial suggests that risperidone may be a promising alternative to conventional medications used for treating the symptoms of Tourette's syndrome. 2 AUTHOR Lombroso PJ AUTHOR Scahill L AUTHOR King RA AUTHOR Lynch KA AUTHOR Chappell PB AUTHOR Peterson BS AUTHOR McDougle CJ AUTHOR Leckman JF TITLE Risperidone treatment of children and adolescents with chronic tic disorders: a preliminary report. SOURCE J Am Acad Child Adolesc Psychiatry; VOL 34, ISS 9, 1995, P1147-52 ABSTRACT OBJECTIVE: The purpose of this trial was to investigate the short-term safety and efficacy of risperidone in the treatment of chronic tic disorders in children and adolescents. METHOD: This was an 11-week open-label trial and included seven subjects (five boys and two girls) with a mean age of 12.9 +/- 1.9 years. The sample included five patients with Tourette's syndrome and two with chronic motor tic disorder. The children were seen at baseline and for two follow-up visits. Three children had a comorbid diagnosis of obsessive-compulsive disorder (OCD). RESULTS: Clinical response, as measured by the Yale Global Tic Severity Scale and the Children's version of the Yale-Brown Obsessive Compulsive Scale, revealed a statistically significant reduction in tic scores ranging from 18% to 66%. One of three children with comorbid OCD showed substantial improvement; the other two subjects showed no change. The most frequent side effect was weight gain, which ranged from 8 to 14 lb. CONCLUSIONS: Risperidone, a neuroleptic with both serotonin- and dopamine-blocking properties, appears to be effective in reducing tic frequency and intensity in children and adolescents with chronic tic disorders. 4 AUTHOR Perry PJ AUTHOR Martinez MR AUTHOR Kuperman S AUTHOR Gaffney GR TITLE Risperidone in the treatment of Tourette's syndrome SOURCE ASHP Midyear Clinical Meeting; VOL 30 ISS Dec 1995, PP-74(D), (REF ) ABSTRACT IPA COPYRIGHT: ASHP Risperidone is a potent serotonin S2 and dopamine D2 antagonist indicated for the treatment of psychoses. However, recent reports suggest that risperidone is useful in treating Tourette's syndrome. Four treatment-refractory patients with Tourette's syndrome (DSM-III-R) were successfully treated with risperidone. Patient 1 was a 17-year-old male with severe vocal tics that resulted in school refusal and motor tics severe enough to cause falls. Prior treatment was only partly effective and the medication was discontinued because of severe adverse drug reactions (ADRs). Four months of risperidone at 1-3 mg/day caused a decrease in tics, extrapyramidal symptoms (EPS), and stuttering, and a return to school. Patient 2, a 28-year-old male, had frequent loud vocal tics and coprolalia for 15 years. Prior neuroleptic treatment produced only minimal improvement and troublesome ADRs. Risperidone 1 mg every other day to 1 mg/day resulted in moderate improvement in the patient's tics and mood. Patient 3, a 7-year-old male had facial motor and vocal tics coexisting with diagnoses of Asperger's Syndrome, attention-deficit hyperactivity disorder, oppositional defiant disorder, enuresis, encopresis, and mixed seizure disorder. Replacement of haloperidol 4 mg/day and paroxetine 80 mg/day with risperidone 0.5-2.5 mg/day for 3 weeks and fluoxetine 20 mg every other day resulted in significant reduction in tics and aggressive behavior and better classroom behavior. Patient 4 was a 48-year-old male with motor and vocal tics, severe obsessive-compulsive disorder marked by perseverative behavior. In the past, the patient was only a partial responder to pimozide primarily because of sedation limiting the dose. Risperidone was titrated to 4 mg/day over 4 weeks and then maintained at this dose for 16 weeks. At follow-up the patient's tics were no longer obvious, the perseveration had decreased, and the OCD symptoms were rated as much improved. The only ADR reported was dose-related drowsiness in patients l and 2. Risperidone was an effective and well-tolerated treatment for Tourette's syndrome. Currently, a 10-week parallel design trial comparing risperidone with clonidine is being conducted by these investigators. 5 AUTHOR Stamenkovic M AUTHOR Aschauer H AUTHOR Kasper S TITLE Risperidone for Tourette's syndrome SOURCE Lancet; VOL 344 ISS Dec 3 1994, P1577-1578, (REF 5) ABSTRACT IPA COPYRIGHT: ASHP The case of a 35-yr-old man with Tourette syndrome whose symptoms improved following therapy with risperidone 2-12 mg daily is reported. The severity of illness was rated with a clinical global impression (CGI) score of 7 at the beginning of the treatment showing a frequency of 50 vocal and 12 motor tics per h. After 2 wk of risperidone 6 mg daily, the CGI score was 5 with a frequency of 7 vocal tics per h and no motor tics. After a further 3 wk of risperidone 8 mg daily no more improvements were reported. The risperidone dose was then increased to 12 mg daily and led to a decrease in the CGI score from 5 to 3, a frequency of 2 vocal tics per h, and no motor tics. During the entire course of treatment no extrapyramidal side effects were detected. It was concluded that risperidone was an effective treatment for this patient with Tourette's syndrome.