Seven Cases of Gilles de la Tourette's Syndrome: Partial Relief with Clonazepam: A Pilot Study

Abstract

The histories of seven consecutive cases of Gilles de la Tourette's syndrome are presented to exemplify the range of clinical manifestations in this disease and to collate preliminary results with the new benzodiazepine, clonazepam, as a possible adjuvant therapy of this disorder. Controlled trials with clonazepam alone and in association with haloperidol are now justified. Five of our 7 patients had a positive RESUME: Nous presentons les histoires de cas de sept patients consecutifs atteints du syndrome de Gilles de la Tourette, afin d'illttstrer la variete des manifestations cliniques et afin de presenter quelques resultats preliminaires de I'emploi du nouveait benzodiazepine, le clonazepam, comma therapie de soutien dans cette maladie. Ces resultats preliminaires justifient des essais controles avec le clonazepam seal et en association avec I'haloperidol.Cinq de nos 7 patients presentment tine family history of tics, and 2 a confirmed family history of gout. Because clonazepam improves myoclonia and tics and because its mechanism of action possibly involves serotonin, we thought it worthwhile to study simultaneously the relative roles of serotonin and dopamine metabolism in the production of tics, and their relationship to possible defects in purine metabolism in Gilles de la Tourette's syndrome.histoirefamiliale positive pour tics, alors qu'tine incidence familiale de goute etait presente chez 2 de nos cas. Pane que le clonazepam est efficace contre les myoclonies ainsi que les tics et puree que son mecanisme d'action implique possiblement la serotonine, nous suggerons qu'il serait utile d'etudier simultanement les roles relalifs de la serotonine et de la dopamine dans la genese des tics, et leurs relations avec un defaut possible du metabolisme des purines dans le syndrome de Gilles de la Tourette.

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

“…Although there have been no placebo-controlled trials in TS, open-label studies have been carried out in adults [94, 274] and adolescents with TS [115, 264]. In a single-blind comparison with clonidine in 20 children, clonazepam was superior in suppressing tics [61].…”

Contemporary assessment and pharmacotherapy of Tourette syndrome

“…Although there are no placebo-controlled trials in TS, open-label studies of the long-acting benzodiazepine, clonazepam, have been carried out in adults 100 and adolescents with TS. 101 At doses ranging from 0.5 to 4 mg/day given in two or three divided doses, clonazepam showed only modest benefits.…”

Emerging Treatment Strategies in Tourette Syndrome

“…Of note, improvements have been found to be superior to clonidine in a subsequent study (Drtilkova et al, 1994). However, other studies have reported modest effectiveness (Gonce & Barbeau, 1977;Steingard et al, 1994).…”