toureete with tics disorder - nimishkum

[ArchivalUser]

drug of choice

[ArchivalUser]

methyphenidate i mean stimulant

[ArchivalUser]

risperidone

[ArchivalUser]

PEMOLINE

[ArchivalUser]

fluphenazine or pimozide

[ArchivalUser]

fds no sttimulant when both together
use desipramine/dextroamphatamine/clonidine or pemoline
but pemoline cause hepatic damage so no no

[ArchivalUser]

Clonidine

[ArchivalUser]

desipramine is doc FOR tics and tourrete
avaoid stimulant i guess

[ArchivalUser]

TS treatment

Treatment is recommended in TS only when its interfering with social interactions, school or job performance or with the activities of daily living.

for tics use either of these fluphenazine, pimozide or tetrabenazine

then there are three very common comorbid conditions or associations with TS

1 if TS plus ADHD use either methylphenidate or dextroamphetamine
2 if TS plus OCD use fluoxetine
3 if TS plus impulse control disorders use clinidine, or guanfacine

Now what to expect probably at step 3 level will be only recognition of TS plus treatment of tics associated with TS.

I think the combination of TS with its comorbid conditions is a psychiatry and neurology board level question.

By the way never ever answer pemoline

So thats the story of Tourette.

[ArchivalUser]

CMDT, 2009

Treatment is symptomatic and may need to be continued indefinitely.

Haloperidol is generally regarded as the drug of choice.
It is started in a low daily dose (0.25 mg) that is gradually increased (by 0.25 mg every 4 or 5 days) until there is maximum benefit with a minimum of side effects or until side effects limit further increments. A total daily dose of between 2 and 8 mg is usually optimal, but higher doses are sometimes necessary.

Treatment with clonazepam (in a dose that depends on response and tolerance) or clonidine (2“5 mcg/kg/d) may also be helpful, and it seems sensible to begin with one of these drugs in order to avoid some of the long-term extrapyramidal side effects of haloperidol.

Phenothiazines, such as fluphenazine (2“15 mg daily), have been used, but patients unresponsive to haloperidol are usually unresponsive to these as well.

Pimozide, an oral dopamine-blocking drug related to haloperidol, may be helpful in patients who cannot tolerate or have not responded to haloperidol. Injection of botulinum toxin type A at the site of the most distressing tics is sometimes worthwhile.

Treatment with risperidone, calcium channel blockers, tetrabenazine, clomipramine, or metoclopramide has yielded mixed results or encouraging findings in preliminary studies that require confirmation. Bilateral high-frequency deep brain stimulation at various sites has been helpful in some, otherwise intractable, cases