Topiramate in treatment of tourette syndrome.
OBJECTIVE
To describe the efficacy and safety of topiramate in the treatment of Tourette syndrome (TS).


METHODS
Charts of subjects whose conditions were diagnosed as tic disorders seen at our clinic from 2003 to 2007 were retrospectively reviewed. Patients who met diagnostic criteria for TS and were started on topiramate at our clinic with at least 1 follow-up visit after beginning topiramate were included. The efficacy of topiramate on a subjective scale, the global impression of response (0 = no response/worse, 1 = mild improvement, 2 = moderate improvement, 3 = marked improvement), and adverse effects were recorded for analysis.


RESULTS
Of 453 subjects, 367 met diagnostic criteria for TS and 41 (11.1%; 34 males) were treated with topiramate for tics for 9.43 +/- 7.03 months (range, 1-27 months). Mean age at onset of tics was 6.93 +/- 2.78 years (range, 2-14 years) and at start of topiramate treatment was 14.83 +/- 5.63 years (range, 9-27 years). The average efficacy on tics was 2.15 +/- 1.11, and 75.6% (n = 31) of subjects had moderate to marked improvement and adverse effects included cognitive/language problems (24.4%, n = 10) and aggression or mood swings (9.8%, n = 4).


CONCLUSIONS
This retrospective chart review suggests that topiramate can be used for tics in TS with at least moderate efficacy and typical adverse effects. Randomized controlled trials are needed.
Kuo
Sheng-Han
SH
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, USA.
Jimenez-Shahed
Joohi
J
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000077236:Topiramate; D005879:Tourette Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose