REMOXIPRIDE IN ADOLESCENTS WITH TOURETTES-SYNDROME - AN OPEN PILOT-STUDY

Remoxipride is a dopamine antagonist with more selective affinity for the mesolimbic dopaminergic system than conventional neuroleptic agent s. The possible therapeutic and adverse effects of remoxipride were in vestigated in 7 adolescents with Tourette's syndrome in an open-label pilot study. The design included a 3-week baseline placebo washin peri od, an 8-week active treatment period, and a 3-week placebo washout pe riod. Active treatment with remoxipride was administered in the dose r ange of 50-250 mg daily. Remoxipride treatment improved severity of il lness ratings in 6 patients and diminished tic ratings in all 7 patien ts. During the placebo washout period, all patients deteriorated both on the severity of illness and on the tic ratings. In a sustained atte ntion task, a slight reduction of workpace was observed, but accuracy and stability of performance were not affected. Verbal and visual memo ry functioning also remained intact. Adverse effects were few and mild in severity. Treatment-emergent nonspecific ST-T changes on the elect rocardiogram were found in 3 patients and bradycardia in 2 patients. A lthough remoxipride has been withdrawn from the market in 1994 because of aplastic anemia, these preliminary findings suggest that Tourette' s syndrome in adolescents might be improved by a dopamine antagonist w ith high specificity for D-2 receptors in the mesolimbic system.