Opiate Agonist and Antagonist Therapy in Tourette Syndrome

Grant Type
Grant Year
Institution Location
Institution Organization Name
University of Rochester
Investigators Name
Majumdar, Lisa, MD

The cause of Tourette Syndrome (TS) remains unknown although disordered brain neurochemical processes are likely involved. Recently, following examination of a post-mortem brain from a patient with TS, a deficiency in dynorphin, a neurotransmitter which acts on opiate receptors, was demonstrated in the globus pallidus, a part of the brain known to be involved in other neurological diseases associated with involuntary movements. These findings suggested that dynorphin , acting on selective brain opiate receptors, may be involved in the etiology of TS. Our study has been designed to clinically evaluate the possible role of brain opiate systems in the treatment of TS. We will study the effects of propoxyphene, which enhances brain opiate activity, and naltrexone, which blocks opiate effects in the brain, on the severity of motor and vocal tics, attentional difficulties, and obsessive-compulsive behavior in TS. Twenty adults (over age 18) will participate in a 24-week study at the University of Rochester Medical Center. Each participant will receive six-week trials of propoxyphene, naltexone, and placebo. Changes in the features of TS during therapy will be assessed by videotape recordings, physical examination, patient self-reports and a series of neuropsychological tests. This study may provide clues to the etiology of TS and, in particular, the possible involvement of brain opiate systems. Additionally, it may provide a new treatment approach for this disorder. Lisa Majumdar, M.D., Roger Kurlan, M.D., Peter Como, Ph.D. University of Rochester, Rochester, NY Award: $23,198 Tourette Association of America Inc. – Research Grant Award 1987