A Pilot Study of metaclopramide in the Treatment of Tourette Syndrome and Chronic Tic Disorders

Grant Type
Clinical
Grant Year
2002-2003
Institution Location
Foreign
Institution Organization Name
Children’s Hospital of Western Ontario Canada
Investigators Name
Nicolson, Rob, MD

The success of pharmacological treatment of Tourette Syndrome and tic disorders in general is often limited by a variety of side effects. Metoclopramide is a dopamine antagonist with a chemical profile that could prove effective in the treatment of tic disorders with a minimum of cognitive and other adverse effects. Anecdotal clinical experience supports this hypothesis, but there have been no controlled studies of metoclopramide in the treatment of tic disorders. The purpose of this study is to evaluate the efficacy and tolerability of metoclopramide in children and adolescents with Tourette Syndrome and chronic tic disorders. Thirty patients aged 7 to 17 will be randomly assigned to receive either metoclopramide or placebo for 56 days. Metoclopramide will be initiated at a dose of 5 mg/day and flexibly titrated to a maximum of 40 mg/day. Behavioral ratings, completed at baseline and 2, 4, 6, and 8 weeks after the initiation of the study, will include the Yale Global Tic Severity Scale, the Clinical Global Impressions Severity Scale for Tourette Syndrome, the Drug Attitude Inventory, the Yale-Brown Obsessive-Compulsive Scale, and the Conners Parent Rating Scale. We hypothesize that metoclopramide will be significantly more effective than placebo in the treatment of tic disorders, and that there will be no significant difference between metoclopramide and placebo in terms of cognitive and affective side effects. If these hypotheses are confirmed, the results will provide support for using metoclopramide as an effective treatment for tic disorders with fewer treatment-limiting adverse effects. Rob Nicolson, M.D., Childrens Hospital of W. Ontario, Div. of Child & Adolescent Psychiatry, London, Ontario, Canada Award: $18,560 This study is funded through the generosity of the William F. Harnisch Foundation Tourette Association of America Inc. – Research Grant Award 2002-2003