Tourette Sdr. - Treatment

Decision need treatment and, if so, choosing a form of treatment depends on the specific tics Tourette syndrome prevents normal development of the child or adult's ability to have a normal life.
In general, the patient is monitored for several months before the organization of a specific treatment plan. The purpose of the first phase of treatment is to establish a reference level of symptoms, identification of difficulties associated with (school, family, relationships with others) and monitor the fluctuations of symptoms, the contexts that generate difficulties and establish a connection.
Even if a child meets the diagnostic criteria, treatment may not be necessary, due to positive relations with others, school performance and satisfactory self-image. In most cases, the severity of Tourette's syndrome becomes apparent within 2 to 3 years after the first manifestation. But often, the symptoms spontaneously amelioareaza late teens.
Drug treatment is only effective for simple and complex motor tics and vocal tics. Treatment is initiated with the lowest dose of medication, then the dose is increased gradually, noting the side effects, and reduce symptoms. The smallest effective dose should be maintained.
Haloperidol
Haloperidol is the drug of choice in the treatment of Tourette's syndrome is effective at low doses, and patients have almost complete remissions with fewer side effects.Side effects include tiredness, weight gain, dysphoria, parkinsonian symptoms, memory impairment, personality changes, phobias, loss of libido, sexual dysfunction. Adverse effects have a considerable impact on autonomy, self-image and the child's cognitive and social competence.
Pimozide
Pimozide (Orap) is a difenilbutilpiperidina approved to treat Tourette syndrome. Its side effects are similar to those caused by haloperidol, but may be less severe and affects a smaller number of patients. It is generally better tolerated than haloperidol, with an equally effective.
Other neuroleptics
Phenothiazines may be an effective alternative to haloperidol or pimozide. Side effects are comparable with observed with haloperidol, but just as pimozide, are better tolerated by patients.Other neuroleptics, effective to a certain number of patients are tiotixen, chlorpromazine and trifluoperazin.
Clonidine
Clonidine is an alpha-adrenergic agonist, which in small doses, lead to a reduction of norepinephrine release. Although the results are less satisfying than when using haloperidol or pimozide, clonidine is considered beneficial in the treatment of Tourette syndrome, mainly due to low incidence of side effects caused.Perhaps more important is that clonidine does not cause tardive dyskinesia.In addition to reducing motor symptoms of Tourette's syndrome and simple voice, clonidine serves amelioarerea attention disorders and complex motor and vocal symptoms.The main side effect of clonidine is sedation, which occurs rapidly during treatment, especially if the dose is increased rapidly. Some patients have xerostomia (dry mouth). In high doses, hypotension may occur and dizziness.
Treatment of obsessive-compulsive disorder in Tourette syndrome
It is known that symptoms of obsessive-compulsive disorder occurs in about 50% of patients with Tourette syndrome. Current research suggests a genetic link between symptoms of obsessive-compulsive disorder and Tourette syndrome.
ClomipramineAmong the drugs used in obsessive-compulsive disorder, antidepressants have proved to be most effective. Clomipramine (Anafranil), a serotonin reuptake inhibitor, is available in three doses (25 mg, 50 mg or 75 mg).Its side effects include dry mouth, dizziness, tremor, constipation and sexual dysfunction.
FluoxetineFluoxetine (Prozac) was administered to children with Tourette syndrome. The results were the reduction of tics and even improving of school activity during therapy with fluoxetine.Its side effects are less toxic than many of clomipramine.