title: Use of the "inverse neuroleptic" metoclopramide in Tourette syndrome: an open case series.
abstract: Neuroleptics are generally highly effective in suppressing tics, but their many adverse effects limit their usefulness. Animal studies have shown that, compared with both typical and atypical neuroleptics, metoclopramide has effects that are regionally circumscribed to rat motor striatum. Based on this observation and two prior case reports, metoclopramide was openly prescribed and individually titrated to diminish tics in 10 patients with Tourette syndrome. All patients improved on the Yale Global Tic Severity Scale by an average of 55%. Although we did not observe frank extrapyramidal symptoms, including tardive dyskinesia, these data are not sufficient to support clinical recommendations because of many limitations, including the absence of systematic ratings of nontic abnormal movements. However, controlled clinical studies and additional basic investigations of metoclopramide are warranted.
authors.affiliation: Department of Neurology, Children's National Medical Center, Washington, DC, USA.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Acosta
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Castellanos
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use*; D008875:Middle Aged; D005879:Tourette Syndrome / Q000188:drug therapy* / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents; D008787:Metoclopramide