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ABSTRACT

Gilles de la Tourette syndrome (TS) is a chronic neuropsychiatric disorder that begins in childhood, in which multiple motor tics and one or more vocal tics are seen concomitantly. In this text, the treatment course of a severe TS case, with complete daily functioning loss, is described. Significant reductions in tics were observed with 8 mg/day risperidone treatment in this case who failed to respond to many neuroleptics. The Yale Global Tic Severity Scale (Y-GTSS) score, which was 85 before treatment, declined to 48. In our case, who used this dosing regimen for six months, the reduced tic status continued after the dose was switched to 6 mg/day, the reduction status was observed to go on after six months. No significant side effect was observed. This case was thought to be important in showing that high dose risperidone might be effective in treatment-resistant TS cases. (Archives of Neuropsychiatry 2009; 46: 206-8)

Key words: Tourette syndrome, risperidone, antipsychotics

ÖZET

Gilles de la Tourette sendromu (TS) çocukluk çaginda baslayan, çogul motor tik ve bir veya daha fazla ses tikinin eslik ettigi kronik bir nöropsikiyatrik bozukluktur. Bu sunumda günlük fonksiyonlarini yapamayacak kadar agir bir TS olgusunun tedavisi anlatilmaktadir. Birçok nöroleptik ile tedaviye cevap vermeyen olgumuzun tiklerinde, 8 mgr- gün risperidon tedavisi ile azalma görülmüstür. Tedaviden önce 85 olan Yale Genel Tik Agirligini Derecelendirme Ölçegi (YGTDÖ) skoru tedaviden sonra 48 olarak tespit edilmistir. Olgumuz bu dozu alti ay boyunca kullanmis, doz 6 mgr-gün olarak azaltildiktan alti ay sonra da tiklerdeki azalma devam etmistir. Önemli bir yan etki ortaya çikmamistir. Bu olgu tedaviye dirençli TS olgularinin tedavisinde yüksek doz risperidonun etkili olabilecegini düsündürmektedir. (Nöropsikiyatri Arsivi 2009; 46: 206-8)

Anahtar kelimeler: Tourette sendromu, risperidon, antipsikotikler

Introduction

Tourette Syndrome (TS) is a neuropsychiatric disorder starting at childhood, and is characterized with multiple motor tics and at least one or more vocal tic (1).

The first step in the treatment of TS is psychoeducation of the patient and the family (2,3).

Clinician must decide whether to use pharmacologic agents or not. Counseling and behavioral arrangements might be sufficient for the patients with moderate symptoms. Medication should only be considered when symptoms disrupt peer relationships and social interaction, and effect academic and occupational performance in a negative way (4,5).

Drugs such...

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