Tourette Syndrome

Clinical features

>> Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

• Multiple vocal and motor tics 
• Starting before the age of 18 and 
• Persisting for a duration of at least one year
• We have excluded other causes of tics.

LOSE

Learning difficulties 

Overactivity 

Social problems 

Emotional disturbances

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Maudsley Prescribing Guidelines (13th Edition) 

They recommend alpha-2 agonists such as Clonidine or Guanfacine as the first-line pharmacological treatment for Tics and Tourette Syndrome 

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American Family Physicians and Canadian Guidelines

Antipsychotics possess a variety of serious adverse effects (Pringsheim et al., 2012) and even though the evidence base for them is strong, we use them in cases not responding to alpha-2 agonists.

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References

1. Taylor, D. (2018). The Maudsley Prescribing Guidelines. The Maudsley Prescribing Guidelines. 
2. Kenney, C., Kuo, S.-H., & Jimenez-Shahed, J. (2008). Tourette’s syndrome. American Family Physician, 77(5), 651–658. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18350763
3. Pringsheim, T., Doja, A., Gorman, D., McKinlay, D., Day, L., Billinghurst, L., … Sandor, P. (2012). Canadian Guidelines for the Evidence-Based Treatment of Tic Disorders: Pharmacotherapy. The Canadian Journal of Psychiatry, 57(3), 133–143.