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DOI: 10.1055/s-0035-1557349
Topiramate in children and adolescents with Tourette syndrome: A case series
Subject Editor:
Publication History
06 March 2006
27 June 2006
Publication Date:
30 July 2015 (online)
Abstract
The objective of this study is to evaluate the effect of topiramate on tics in patients with Tourette syndrome (TS). TS is a complex neurobehavioral disorder that emerges in childhood with widely varying patterns of intermittent involuntary/semivoluntary movements expressed as motor and vocal tics. Although neuroleptics are effective anti-tic agents, side effects such as tardive dyskinesia, weight gain, and hepatotoxicity can limit their usefulness. Our use of topiramate followed reports of its effectiveness in reducing involuntary movements in patients with essential tremor. Retrospective patient record was audited using a standardized data collection form in a general child neurology practice. Charts for topiramate-treated patients meeting diagnostic criteria for TS were reviewed. Data for tics, behavior disorders, medication history, and topiramate treatment were extracted. The Shapiro tic severity scale was used to quantify change from baseline. Of 39 children/adolescents with TS treated with topiramate, tic severity was reduced at least 50% in 23 (59%) patients, did not change in five (13%) patients and worsened in two (5%) patients. Topiramate was discontinued and not restarted due to side effects in seven (18%) patients. Topiramate appears to be useful in suppressing tics in patients with TS, but double-blind, randomized controlled studies are needed to document its efficacy.