A Double-Blind Comparison of Desipramine and Placebo in Children with Tic Disorder or Tourette Syndrome and Attention Deficit Hyperactivity Disorder

Grant Type
Clinical
Grant Year
1993
Institution Location
MA
Institution Organization Name
Massachusetts General Hospital
Investigators Name
Spencer, Thomas, MD

Our child psychiatry research group previously reported findings that desipramine (DMI), a tricyclic antidepressant, is an effective treatment for children with attention deficit-hyperactivity disorder (ADHD) with adequate (robust) dosage. In that study and subsequent reports, our group has established safety parameters in treating children with desipramine with careful, routine monitoring of growth and cardiac function. Recently we reviewed the clinical experience of all children with ADHD and Tic disorder or Tourette Syndrome (TS) that were treated with DMI (N=33) or nortriptyline (NOR; N=12) in our clinic and a neurology service specializing in movement disorders. We reported preliminary evidence that these tricyclic antidepressants, in robust dosage, ameliorate tics and ADHD. In all, 67-82% had significant improvement in tic symptomatology and 80-92% had significantly improved ADHD symptoms over a 16-month period. While patients had multiple coexisting psychiatric diagnoses, improvement of tic symptoms was not affected by the presence or absence of any of these other conditions. Coexisting diagnoses included anxiety (12%) and depression (45%), conditions also potentially responsive to DMI and NOR. Further, treatment with both agents was well tolerated with few adverse effects. The purpose of this study will be to examine the effectiveness and safety of DMI treatment of tic symptoms and ADHD, using comprehensive assessment methodology and robust dosage, in children with tic disorders and the full array of naturally occurring associated psychiatric diagnoses. To this end we are conducting a double-blind study comparing DMI to placebo. Thomas J. Spencer, M.D. Massachusetts General Hospital, Boston, MA Award $25,000 Tourette Association of America Inc. – Research Grant Award 1993