Clinical pharmacology of nondopaminergic drugs in tourette syndrome.

Source

Centre de Référence National Maladie Rare: ‘Syndrome Gilles de la Tourette’, Département de Neurologie, Pôle des Maladies du Système Nerveux, Paris, France; Centre de Recherche de l’Institut du Cerveau et de la Moelle Epinière, UPMC/INSERM UMR_S975; CNRS UMR 7225, Paris, France. Electronic address: andreas.hartmann@psl.aphp.fr.

Abstract

Treatment of tics and Gilles de la Tourette syndrome (GTS) by nondopaminergic drugs was initiated more than three decades ago. These approaches were driven by the wish to circumvent antipsychotic-related side effects (metabolic disturbances, parkinsonian syndromes, tardive dyskinesia) or to use these treatments as a valuable add-on therapy in patients at least partially refractory to antipsychotics. In this review, we will therefore discuss the potential value of treating tics with alpha2 receptor agonists, nicotine, tetrabenazine, GABA agonists, botulinum toxin, cannabinoids, and immune modulators (plasmapheresis, intravenous immunoglobulins, antibiotic prophylaxis). Future directions for clinical trials based on our expanding understanding of the pathophysiology of GTS with regard to cholinergic, glutamatergic, and histaminergic neurotransmission will also be briefly outlined.
© 2013 Elsevier Inc. All rights reserved.

KEYWORDS:

Alpha2 receptor agonists, Botulinum toxin, Cannabinoids, GABA agonists, Gilles de la Tourette syndrome, Immune modulation, Nicotine, Nondopaminergic drugs, Tetrabenazine, Tics