Risperidone Versus Pimozide in Tourette's Disorder: A Comparative Double-Blind Parallel-Group Study
J Clin Psychiatry 2001;62(1):50-56
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The treatment of Tourette's disorder
with classical neuroleptics is limited by their side effects.
Risperidone is a new efficacious antipsychotic with a low
propensity for extrapyramidal side effects. To establish
risperidone's therapeutic potential in Tourette's disorder, we
studied the safety and efficacy of risperidone in comparison with
pimozide in patients with Tourette's disorder diagnosed according
Method: In a 12-week, multicenter,
double-blind, parallel-group study, 26 patients were treated with
risperidone (mean daily dose = 3.8 mg), and 24 patients were
treated with pimozide (mean daily dose = 2.9 mg).
Results: There was significant
improvement of tics with respect to the Tourette's Symptom
Severity Scale (TSSS) for both groups. Forty-one patients
completed the study. At endpoint, 54% (14/26) of the risperidone
patients and 38% (9/24) of the pimozide patients had only very
mild or no symptoms on the global severity rating of the TSSS.
Both treatment groups had improved significantly at endpoint in
regard to Global Assessment of Functioning and Clinical Global
Impressions scale outcomes. Symptoms of anxiety and depressive
mood improved significantly from baseline in both groups.
Obsessive-compulsive behavior improvement reached significance
only in the risperidone group. Although the severity of
extrapyramidal side effects was low in both groups, fewer
patients in the risperidone group reported extrapyramidal side
effects (N = 4) compared with the pimozide group (N = 8).
Depression, fatigue, and somnolence were reported as the most
prominent side effects in both treatment groups.
Conclusion: Both drugs were efficacious
and well tolerated in patients with Tourette's disorder.
Risperidone may become the first-line drug in the treatment of
Tourette's disorder owing to a more favorable efficacy and