Tic reduction with risperidone versus pimozide in a randomized, double-blind, crossover trial.
OBJECTIVE
To compare the tic suppression, electrocardiogram (ECG) changes, weight gain, and side effect profiles of pimozide versus risperidone in children and adolescents with tic disorders.


METHODS
This was a randomized, double-blind, crossover (evaluable patient analysis) study. Nineteen children aged 7 to 17 years with Tourette's or chronic motor tic disorder were randomized to 4 weeks of treatment with pimozide or risperidone, followed by the alternate treatment after a 2-week placebo washout. The primary efficacy outcome measure was change in tic severity assessed by the Yale Global Tic Severity Scale (YGTSS). ECG results, weight gain, and side effects were also compared.


RESULTS
Compared to pimozide treatment, risperidone treatment was associated with significantly lower tic severity scores (YGTSS: baseline 43.3 +/- 17.5, pimozide 34.2 +/- 14.2, risperidone 25.2 +/- 13.6; p =.05). Weight gain during the 4-week treatment periods was greater for risperidone (mean 1.9 kg) than pimozide (1.0 kg). No patient suffered a serious adverse event, but 6 of 19 subjects failed to complete the protocol. Neither medication was associated with ECG changes.


CONCLUSIONS
In this study, risperidone appeared superior to pimozide for tic suppression but was associated with greater weight gain.
Gilbert
Donald L
DL
Department of Neurology, Cincinnati Children's Hospital Medical Center, Division of Developmental and Behavioral Sciences. Children's Mercy Hospital, Kansas City, KS, USA. d.gilbert@cchmc.org
Batterson
J Robert
JR
Sethuraman
Gopalan
G
Sallee
Floyd R
FR
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010868:Pimozide / Q000627:therapeutic use*; D018967:Risperidone / Q000627:therapeutic use*; D013981:Tic Disorders / Q000175:diagnosis / Q000188:drug therapy*
D014150:Antipsychotic Agents; D010868:Pimozide; D018967:Risperidone