An open-label study of the treatment efficacy of olanzapine for Tourette's disorder.

Abstract

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 (> or = 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 > or = 20 points, and 6 (75%) demonstrated reductions by > or = 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.

• Authors: C L Budman, A Gayer, M Lesser, Q Shi, R D Bruun
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 62 Issue 4 Pg. 290-4 (Apr 2001) ISSN: 0160-6689 [Print] United States
• PMID: 11379844 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• Benzodiazepines
• Pirenzepine
• Olanzapine

Topics

• Adult
• Antipsychotic Agents (administration & dosage, therapeutic use)
• Attention Deficit Disorder with Hyperactivity (diagnosis, epidemiology)
• Benzodiazepines
• Comorbidity
• Drug Administration Schedule
• Female
• Humans
• Male
• Olanzapine
• Pirenzepine (administration & dosage, analogs & derivatives, therapeutic use)
• Psychiatric Status Rating Scales (statistics & numerical data)
• Severity of Illness Index
• Tourette Syndrome (diagnosis, drug therapy, epidemiology)
• Treatment Outcome