Tourette's syndrome improvement with pergolide in a randomized, double-blind, crossover trial.
OBJECTIVE
To determine whether pergolide, a mixed D1-D2-D3 dopamine agonist, is efficacious and safe in the treatment of children with Tourette's syndrome.


BACKGROUND
Neuroleptics, which block dopamine transmission, are currently used for treatment of children with severe tics, but major side effects and limited efficacy reduce clinical utility. Prior open-label reports of pergolide suggest potential benefit.


METHODS
The authors enrolled 24 children age 7 to 17 years with Tourette's disorder, chronic motor tic disorder, or chronic vocal tic disorder by Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria, plus severity criteria on the Yale Global Tic Severity Scale (YGTSS) of > or =20, in a double-blind, placebo-controlled, crossover study. Children were randomized to receive either placebo or up to 300 microg/day pergolide for the first 6-week treatment period, with a 2-week placebo washout, followed by crossover to the alternate treatment. The primary outcome measure was tic severity assessed by YGTSS.


RESULTS
Compared with placebo treatment, pergolide treatment was associated with significantly lower YGTSS scores (42.0 +/- 20.4 versus 23.5 +/- 18.7; F = 12.0, df = 1, 17, p = 0.0011). No patient had a serious adverse event and pergolide was well tolerated.


CONCLUSIONS
In this randomized, placebo-controlled, crossover trial, pergolide appeared to be a safe and efficacious treatment for Tourette's syndrome in children.
Gilbert
D L
DL
Children's Hospital Medical Center, Department of Neurology, University of Cincinnati, OH 45229-3039, USA. d.gilbert@chmcc.org
Sethuraman
G
G
Sine
L
L
Peters
S
S
Sallee
F R
FR
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D004311:Double-Blind Method; D006801:Humans; D010479:Pergolide / Q000009:adverse effects / Q000627:therapeutic use*; D011379:Prognosis; D005879:Tourette Syndrome / Q000188:drug therapy* / Q000503:physiopathology
D010479:Pergolide