An Open-Label Study of the Treatment Efficacy of Olanzapine for Tourette's Disorder
Cathy L. Budman, Alex Gayer, Martin Lesser, Qiuhu Shi, and Ruth D. Bruun
Background: An open-label trial was performed to
explore efficacy and safety of olanzapine, an atypical
neuroleptic with diverse receptor activity including both
dopamine-2 and serotonin-2A and -2C antagonism, for treatment of
Tourette's disorder.
Method: Ten adult patients aged 20 to 44 years
with Tourette's disorder were treated using an open-label,
flexible dosing schedule for 8 weeks. Three patients who
continued olanzapine were reevaluated after 6 months. Three
subjects were psychotropic medication naive, 5 patients
experienced intolerable side effects with conventional
neuroleptics, and 2 patients had remote (>= 10 years)
successful response to conventional neuroleptics. Tic severity
was rated by the Yale Global Tic Severity Scale; weight, vital
signs, and adverse effects were assessed weekly.
Electrocardiogram, laboratory studies, and comorbid symptoms,
assessed by the Yale-Brown Obsessive Compulsive Scale and ADHD
Behavior Checklist for Adults, were measured at baseline and at
week 8.
Results: Two of 10 patients prematurely
discontinued olanzapine owing to excessive sedation. Of 8
patients who completed the 8-week trial, 4 (50%) demonstrated
reduction of global tic severity scores by >= 20 points, and 6
(75%) demonstrated reductions by >= 10 points. No significant
changes in comorbid symptoms were demonstrated. Sedation, weight
gain, increased appetite, dry mouth, and transient asymptomatic
hypoglycemia were the most common side effects. Tic improvements
were maintained in 3 patients reassessed 6 months later. Final
olanzapine dosages ranged from 2.5 mg to 20 mg daily (mean = 10.9
mg/day).
Conclusion: This open-label study suggests that
olanzapine should be explored as a potential alternative to
conventional neuroleptic medications for treatment of motor tics
and Tourette's disorder.
J Clin Psychiatry 2001;62(4):290-294
© Copyright 2001 Physicians Postgraduate Press, Inc.