Skip to main content
SpringerLink
Log in

Novel Pharmacological Approaches for Tourette Syndrome

  • Tourette’s Syndrome (E Ricketts and M Yadegar, Section Editors)
  • Published:
Current Developmental Disorders Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

The need to develop novel pharmacological approaches for TS is balanced by the necessity for interventions to be safe and tolerable. This review provides an overview of studies of medications for TS over the last 3 years.

Recent Findings

Four studies of deutetrabenazine and valbenazine in TS failed in their primary outcomes. Ecopipam was more effective than placebo in reducing tics in children. Preliminary evidence suggests that a new endocannabinoid modulator (ABX-1431) has an acute effect on tics in adults. Intravenous valproic acid was more effective than oral aripiprazole in children with severe tics. Taurine added to tiapride was superior to placebo added to tiapride in decreasing tics in children. The clonidine patch and vitamin D decreased tics in children compared with baseline assessment. Behavioral therapy was as effective as pharmacotherapy in decreasing tics in children.

Summary

There is emerging evidence for new treatments for tics, but more methodologically rigorous studies are needed to inform practice recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Wolicki SB, Bitsko RH, Danielson ML, Holbrook JR, Zablotsky B, Walkup JT, et al. Children with Tourette syndrome in the United States: parent-reported diagnosis, co-occurring disorders, severity, and influence of activities on tics. J Dev Behav Pediatr. 2019;40(6):407–14. https://doi.org/10.1097/dbp.0000000000000667.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Groth C, Mol Debes N, Rask CU, Lange T, Skov L. Course of Tourette syndrome and comorbidities in a large prospective clinical study. J Am Acad Child Adolesc Psychiatry. 2017;56(4):304–12. https://doi.org/10.1016/j.jaac.2017.01.010.

    Article  PubMed  Google Scholar 

  3. •• Pringsheim T, Holler-Managan Y, Okun MS, Jankovic J, Piacentini J, Cavanna AE, et al. Comprehensive systematic review summary: treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. 2019;92(19):907–15. https://doi.org/10.1212/wnl.0000000000007467. Systematic review of treatment studies to 2017.

    Article  PubMed  PubMed Central  Google Scholar 

  4. •• Pringsheim T, Okun MS, Müller-Vahl K, Martino D, Jankovic J, Cavanna AE, et al. Practice guideline recommendations summary: treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. 2019;92(19):896–906. https://doi.org/10.1212/wnl.0000000000007466. Practice guidelines for assessment and management of tics.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gronseth GSCJ, Gloss D, on behalf of the Guideline Development, Dissemination, and, Implementation Subcommittee of the American Academy of Neurology, et al. Clinical Practice Guideline Process Manual. Minneapolis: The American Academy of Neurology; 2017.

    Google Scholar 

  6. Anonymous. Emerging Science Abstracts - 70th American Academy of Neurology Annual Meeting, AAN 2018. Neurology conference: 70th annual meeting of the American Academy of Neurology, AAN. 2018;90(24).

  7. Jankovic J, Coffey B, Claassen DO, Stamler D, Gertz BJ, Garofalo EA, et al. 152 development of deutetrabenazine as a potential new non-antipsychotic treatment for Tourette syndrome in children and adolescents. CNS Spectr. 2020;25(2):297.

    Article  Google Scholar 

  8. Neurocrine Biosciences. Neurocrine Biosciences announces topline data from phase IIb T-force GOLD study demonstrating valbenazine did not meet primary endpoint in pediatric patients with Tourette syndrome. 2018. Accessed May 15 2020.

  9. Neurocrine Biosciences. Safety and efficacy study of NBI-98854 in adults with Tourette syndrome. US National Library of Medicine, Clinicaltrials.gov. 2020. Accessed July 6 2020 2020.

  10. • Gilbert DL, Murphy TK, Jankovic J, Budman CL, Black KJ, Kurlan RM, et al. Ecopipam, a D1 receptor antagonist, for treatment of Tourette syndrome in children: a randomized, placebo-controlled crossover study. Mov Disord. 2018;33(8):1272–80. https://doi.org/10.1002/mds.27457. Trial of ecopipam for tics.

    Article  PubMed  CAS  Google Scholar 

  11. Tao D, Zhong T, Ma S, Li J, Li X. Randomized controlled clinical trial comparing the efficacy and tolerability of aripiprazole and sodium valproate in the treatment of Tourette syndrome. Ann General Psychiatry. 2019;18:24. https://doi.org/10.1186/s12991-019-0245-3.

  12. Song PP, Jiang L, Li XJ, Hong SQ, Li SZ, Hu Y. The efficacy and tolerability of the clonidine transdermal patch in the treatment for children with tic disorders: a prospective, open, single-group, self-controlled study. Front Neurol. 2017;8:32. https://doi.org/10.3389/fneur.2017.00032.

  13. Ding L, Yang Z, Liu G, Ran N, Yi M, Li H, et al. Safety and efficacy of taurine as an add-on treatment for tics in youngsters. Eur J Neurol. 2020;27(3):490–7.

    Article  CAS  Google Scholar 

  14. Li HH, Xu ZD, Wang B, Feng JY, Dong HY, Jia FY. Clinical improvement following vitamin D3 supplementation in children with chronic tic disorders. Neuropsychiatr Dis Treat. 2019;15:2443–50.

    Article  CAS  Google Scholar 

  15. • Rizzo R, Pellico A, Silvestri PR, Chiarotti F, Cardona F. A randomized controlled trial comparing behavioral, educational, and pharmacological treatments in youths with chronic tic disorder or Tourette syndrome. Front Psychiatry. 2018;9:100. https://doi.org/10.3389/fpsyt.2018.00100. Trial comparing pharmacotherapy to behavioural therapy and psychoeducation.

  16. Jankovic J, Beach J. Long-term effects of tetrabenazine in hyperkinetic movement disorders. Neurology. 1997;48(2):358–62. https://doi.org/10.1212/wnl.48.2.358.

    Article  PubMed  CAS  Google Scholar 

  17. Porta M, Sassi M, Cavallazzi M, Fornari M, Brambilla A, Servello D. Tourette's syndrome and role of tetrabenazine: review and personal experience. Clin Drug Investig. 2008;28(7):443–59. https://doi.org/10.2165/00044011-200828070-00006.

    Article  PubMed  CAS  Google Scholar 

  18. Yang CS, Zhang LL, Lin YZ, Guo Q. Sodium valproate for the treatment of Tourette’s syndrome in children: a systematic review and meta-analysis. Psychiatry Res. 2015;226(2–3):411–7. https://doi.org/10.1016/j.psychres.2014.08.058.

    Article  PubMed  CAS  Google Scholar 

  19. Genel F, Arslanoglu S, Uran N, Saylan B. Sydenham’s chorea: clinical findings and comparison of the efficacies of sodium valproate and carbamazepine regimens. Brain Dev. 2002;24(2):73–6. https://doi.org/10.1016/s0387-7604(01)00404-1.

    Article  PubMed  Google Scholar 

  20. Sethi KD, Patel BP. Inconsistent response to divalproex sodium in hemichorea/hemiballism. Neurology. 1990;40(10):1630–1. https://doi.org/10.1212/wnl.40.10.1630.

    Article  PubMed  CAS  Google Scholar 

  21. Lancman ME, Asconapé JJ, Penry JK. Choreiform movements associated with the use of valproate. Arch Neurol. 1994;51(7):702–4. https://doi.org/10.1001/archneur.1994.00540190086020.

    Article  PubMed  CAS  Google Scholar 

  22. Brugger F, Bhatia KP, Besag FM. Valproate-associated parkinsonism: a critical review of the literature. CNS Drugs. 2016;30(6):527–40. https://doi.org/10.1007/s40263-016-0341-8.

    Article  PubMed  CAS  Google Scholar 

  23. Statistics Canada. Canadian Health Measures Survey Cycle 2. 2011. https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/chart/11727-01-chart1-eng.htm. Accessed June 29 2020.

  24. Anjum I, Jaffery SS, Fayyaz M, Samoo Z, Anjum S. The role of vitamin D in brain health: a mini literature review. Cureus. 2018;10(7):e2960. https://doi.org/10.7759/cureus.2960.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Cothros N, Martino D, McMorris C, Stewart D, Tehrani A, Pringsheim T. Prescriptions for alpha agonists and antipsychotics in children and youth with tic disorders: a pharmacoepidemiologic study. Tremor Other Hyperkinet Mov (N Y). 2019;9. https://doi.org/10.7916/tohm.v0.645.

  26. Smith JL, Gregory S, McBride N, Murphy TK, Storch EA. Outpatient treatment of tic disorders among children and adults. Mov Disord Clin Pract. 2017;4(4):559–67.

    Article  Google Scholar 

  27. Carulla-Roig M, Isomura K, Perez-Vigil A, Larsson H, Hellner C, Mataix-Cols D, et al. Pharmacoepidemiology of Tourette and chronic tic disorders in Sweden 2005-2013. J Child Adolesc Psychopharmacol. 2018;28(9):637–45. https://doi.org/10.1089/cap.2017.0169.

    Article  PubMed  Google Scholar 

  28. Choi S, Lee H, Song DH, Cheon KA. Population-based epidemiology of pediatric patients with treated tic disorders from real-world evidence in Korea. J Child Adolesc Psychopharmacol. 2019;29(10):764–72.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada

    Julian Fletcher, Davide Martino & Tamara Pringsheim

  2. Mathison Centre for Mental Health Research & Education, 3280 Hospital Drive NW, Calgary, Canada

    Tamara Pringsheim

Authors
  1. Julian Fletcher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Davide Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tamara Pringsheim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tamara Pringsheim.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Tourette’s Syndrome

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fletcher, J., Martino, D. & Pringsheim, T. Novel Pharmacological Approaches for Tourette Syndrome. Curr Dev Disord Rep 7, 270–276 (2020). https://doi.org/10.1007/s40474-020-00213-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40474-020-00213-x

Keywords

Search

Navigation