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Gilles de la Tourette syndrome (TS), characterized by chronic multiple motor tics and one or more vocal tics,1 has not been well recognized in adults. There are many studies in the literature that provide evidence of bipolar disorder being one of the comorbid disorders in adult patients with TS.2 Treatment of TS in adults with bipolar disorder is very challenging and has not been exclusively studied.
Case Report
RS was a 41-year-old single, white male who lived alone in an apartment and assisted his father in his plumbing business. RS had a history of type one bipolar disorder for more than 3 years, alcohol dependence with physiological dependence in early partial remission, sedative-hypnotic abuse, and TS. He was last evaluated in an outpatient department during a regular follow-up session. He was very satisfied and compliant with the medications, and he had been regularly following up in the out-patient clinic.
The patient's medication included pimozide 1 mg orally twice daily, quetiapine 100 mg orally twice daily, trazadone 100 mg orally at bedtime, lamotrigine 50 mg, and clonazepam 1 mg three times...