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Tourette Disorder

Updated : May 14, 2023





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

clonidine 

(Off-Label)
Oral administration with 0.0025 to 0.015 mg/kg/day in duration that ranges from 6 weeks to 3 months:



Dose Adjustments

Not Available

 

aripiprazole 

<6 years: Safety and efficacy not established
6 to 18years (<50 kg):
Start with 2 mg/day orally (PO), increasing to 5 mg/day after two days. If patients are not experiencing good suppression of tics at 5 mg/day, they may escalate to 10 mg/day. Dosage adjustments should be made progressively at no less than one-week intervals.
6 to 18years (>50 kg):
Take 2 mg orally daily for two days, 5 mg for five days, and 10 mg on day 8. The daily dosage can be increased to 20 mg for patients who do not attain optimal tic control. Dosage adjustments should be made progressively in 5 mg/day increments at no less than one-week intervals.



Dose Adjustments

Poor metabolizers and cytochrome-P 450 inhibitors
Poor metabolizers of CYP2D6: Administer half of the suggested dosage.
Known CYP2D6 poor metabolizers concurrently receiving potent CYP3A4 inhibitors: Administer one-fourth of the prescribed dose (i.e., a 75% reduction).
Potent inhibitors of CYP2D6 or CYP3A4: Administer half the suggested dose
Strong CYP2D6 AND CYP3A4 inhibitors: Administer a quarter of the recommended dose (or a 75% reduction in dosage).
Strong inducers of CYP3A4: double the recommended dose over 1 to 2 weeks.

ziprasidone 

5 mg daily on days 1 to 3
Titrated to 40 mg daily divided every 12 hours from days 4 to28.



pergolide 

for 8 to 17 years old:
Take a dose of 25 mcg daily then 2 to 3 days later the dose was titrated up to 50 mcg thrice daily



 

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References

Tourette Disorder

Updated : May 14, 2023




clonidine 

(Off-Label)
Oral administration with 0.0025 to 0.015 mg/kg/day in duration that ranges from 6 weeks to 3 months:



Dose Adjustments

Not Available

aripiprazole 

<6 years: Safety and efficacy not established
6 to 18years (<50 kg):
Start with 2 mg/day orally (PO), increasing to 5 mg/day after two days. If patients are not experiencing good suppression of tics at 5 mg/day, they may escalate to 10 mg/day. Dosage adjustments should be made progressively at no less than one-week intervals.
6 to 18years (>50 kg):
Take 2 mg orally daily for two days, 5 mg for five days, and 10 mg on day 8. The daily dosage can be increased to 20 mg for patients who do not attain optimal tic control. Dosage adjustments should be made progressively in 5 mg/day increments at no less than one-week intervals.



Dose Adjustments

Poor metabolizers and cytochrome-P 450 inhibitors
Poor metabolizers of CYP2D6: Administer half of the suggested dosage.
Known CYP2D6 poor metabolizers concurrently receiving potent CYP3A4 inhibitors: Administer one-fourth of the prescribed dose (i.e., a 75% reduction).
Potent inhibitors of CYP2D6 or CYP3A4: Administer half the suggested dose
Strong CYP2D6 AND CYP3A4 inhibitors: Administer a quarter of the recommended dose (or a 75% reduction in dosage).
Strong inducers of CYP3A4: double the recommended dose over 1 to 2 weeks.

ziprasidone 

5 mg daily on days 1 to 3
Titrated to 40 mg daily divided every 12 hours from days 4 to28.



pergolide 

for 8 to 17 years old:
Take a dose of 25 mcg daily then 2 to 3 days later the dose was titrated up to 50 mcg thrice daily