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NEUROLOGY 1987;37:1828
© 1987 American Academy of Neurology

Treatment of Gilles de la Tourette's syndrome

ight-year, practice-based experience in a predominantly adult population

M-Marsel Mesulam, MD and Ronald C. Petersen. MD

Division of Neuroscience and Behavioral Neurology, Harvard Neurology Department and Dana Research Institute, Beth Israel Hospital, Boston, MA.

Over 86% of 58 patients with Gilles de la Tourette's syndrome achieved effective pharmacologic control of the symptoms for 3 months or longer. Differences in response patterns were common among patients and required individualized tailoring of management. Dopamine-blocking neuroleptics were the mainstay of therapy. However, frequent mid-course alterations were required as previously successful drugs stopped working or as their side effects became intolerable, While haloperidol and now pimozide are most frequently used, trifluoperazine and thiothixene can provide superior relief in individual patients. A combination of neuroleptics or even a rotation from one to another may occasionally become necessary. No tardive dyskinesia was encountered in this population. Clonidine proved inferior to neuroleptics in the treatment of the motor and vocal tics, but may have a role in some patients with prominent obsessive-compulsive symptomatology.

Address correspondence and reprint requests to Dr. Mesulam, Neurological Unit, Beth Israel Hospital, 330 Brookline Avenue, Boston, MA 02215.

Received January 20, 1987. Accepted for publication in final form March 6, 1987.






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