A randomized, double-blind, placebo-controlled trial of metoclopramide for the treatment of Tourette's disorder.
OBJECTIVE
The pattern of dopamine antagonism by metoclopramide suggests benefits in the treatment of tic disorders. The purpose of this study was to examine the efficacy and safety of metoclopramide in the treatment of children and adolescents with tic disorders.


METHODS
Twenty-seven medication-free patients (age 11.9 +/- 2.7 years) with Tourette's disorder or a chronic tic disorder participated in an 8-week double-blind, randomized, placebo-controlled trial of metoclopramide. Metoclopramide was started at 5 mg daily and titrated as needed to a maximum dose of 40 mg daily. Tics were rated every 2 weeks, and adverse effects, including weight, cardiac, and laboratory measures, were monitored.


RESULTS
After 8 weeks of treatment, subjects receiving metoclopramide showed a 39% reduction in their total tic score on the Yale Global Tic Severity Scale, while subjects receiving placebo showed only a 13% reduction in tic severity (p = .001). Metoclopramide was well tolerated with no significant laboratory or cardiac changes noted other than an increase in serum prolactin.


CONCLUSIONS
The results of this small controlled study suggest that metoclopramide is an effective and well-tolerated treatment for children and adolescents with tic disorders. Further trials are needed to confirm its efficacy and safety in pediatric patients and adults.
Nicolson
Rob
R
Department of Psychiatry, The University of Western Ontario, London, Ontario, Canada. rob.nicolson@sympatico.ca
Craven-Thuss
Beth
B
Smith
Judy
J
McKinlay
B Duncan
BD
Castellanos
F Xavier
FX
D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D005879:Tourette Syndrome / Q000175:diagnosis / Q000188:drug therapy*
D018492:Dopamine Antagonists; D008787:Metoclopramide