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From the Child Study Center (Drs. Scahill, Leckman, Schultz, and Peterson, and L. Katsovich) and School of Nursing (Dr. Scahill), Yale University, New Haven, CT; and Columbia University (Dr. Peterson), New York, NY.
Address correspondence and reprint requests to Dr. Larry Scahill, Associate Professor of Nursing & Child Psychiatry, Yale Child Study Center, New Haven, CT 06520; e-mail: lawrence.scahill{at}yale.edu
Objective: To evaluate the efficacy and safety of risperidone in children and adults with Tourette syndrome.
Methods: This was an 8-week, randomized, double-blind, placebo-controlled trial. The primary outcome measure was the Total Tic score of the Yale Global Tic Severity Scale (YGTSS).
Results: Thirty-four medication-free subjects (26 children and 8 adults) ranging in age from 6 to 62 years (mean = 19.7 ± 17.0 years) participated. YGTSS Total Tic scores were similar at baseline (26.0 ± 5.1 for risperidone vs 27.4 ± 8.5 for placebo). After 8 weeks of treatment (mean daily dose of 2.5 ± 0.85), the 16 subjects on risperidone showed a 32% reduction in tic severity from baseline, compared to a 7% reduction for placebo patients (n = 18) (F[2,64] = 6.07; p = 0.004). The 12 children randomized to risperidone showed a 36% reduction in tic symptoms compared to an 11% decrease in the 14 children on placebo (F[2,48] = 6.38; p = 0.004). Two children on risperidone showed acute social phobia, which resolved with dose reduction in one subject but resulted in medication discontinuation in the other. A mean increase in body weight of 2.8 kg was observed in the risperidone group compared to no change in placebo (F[2,64] = 10.68; p = 0.0001). No extrapyramidal symptoms and no clinically significant alterations in cardiac conduction times or laboratory measures were observed.
Conclusion: Risperidone appears to be safe and effective for short-term treatment of tics in children or adults with Tourette syndrome. Longer-term studies are needed to evaluate the durability of efficacy and safety over time.
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