title: Rebound phenomena in Tourette's syndrome after abrupt withdrawal of clonidine. Behavioral, cardiovascular, and neurochemical effects.
abstract: Following an open trial of clonidine hydrochloride (3 to 8 micrograms/kg/day for 12 weeks), we studied the behavioral, cardiovascular, and neurochemical effects of abrupt clonidine withdrawal in seven patients with Tourette's syndrome aged 9 to 13 years. Five patients showed marked worsening of tics. After reinitiation of clonidine therapy, the time required for patients to return to prewithdrawal levels of tic symptoms ranged from two weeks to four months. Increases in motor restlessness, blood pressure, and pulse rate were also observed over the 72-hour period following abrupt withdrawal of clonidine. Plasma levels of free 3-methoxy-4-hydroxyphenylglycol, homovanillic acid, and urinary excretion of norepinephrine and epinephrine increased during the withdrawal period. Clonidine's effectiveness in Tourette's syndrome may be dependent on changes in dopaminergic as well as adrenergic mechanisms.
authors.forename: J F
authors.initials: JF
authors.lastname: Leckman
authors.forename: S
authors.initials: S
authors.lastname: Ort
authors.forename: K A
authors.initials: KA
authors.lastname: Caruso
authors.forename: G M
authors.initials: GM
authors.lastname: Anderson
authors.forename: M A
authors.initials: MA
authors.lastname: Riddle
authors.forename: D J
authors.initials: DJ
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D003000:Clonidine / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D004837:Epinephrine / Q000652:urine; D006719:Homovanillic Acid / Q000097:blood; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood; D009638:Norepinephrine / Q000652:urine; D011674:Pulse; D012701:Serotonin / Q000097:blood; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005879:Tourette Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology
chemical_list: D012701:Serotonin; D008734:Methoxyhydroxyphenylglycol; D003000:Clonidine; D009638:Norepinephrine; D006719:Homovanillic Acid; D004837:Epinephrine