PROLACTIN MONITORING OF HALOPERIDOL AND PIMOZIDE TREATMENT IN CHILDREN WITH TOURETTES-SYNDROME

Neuroleptic therapy of children and adolescents,with Tourette's syndro me (GTS) is associated with unpredictable outcome and adverse drug res ponses (i.e., extrapyramidal symptoms). Assessing the potential outcom es in GTS from a physiologic marker such as plasma prolactin concentra tion is important in limiting exposure and optimizing therapy. In a do uble-blind, placebo-controlled, double crossover comparison of pimozid e and haloperidol therapy, prolactin, tic severity, and extrapyramidal symptoms were assessed at a 6-week end point. Twenty-six GTS patients (10.5 +/- 2.6 years), experienced clinical response rates of 69% on 3 .4 +/- 1.6 mg pimozide and 65% on 3.5 +/- 2.2 mg/day haloperidol, Pimo zide responders demonstrate elevated prolactin (26.1 +/- 11.8 ng/mL) v ersus pimozide nonresponders (10.5 +/- 3.8 ng/mL) (p =.05) and haloper idol treated patients (p =.05). Prolactin may be a marker for tic resp onse to pimozide, and conversely, a potential marker for haloperidol-r elated incidence of extrapyramidal symptoms during halaperidol therapy . (C) 1996 Society of Biological Psychiatry