The Use of Levetiracetam in the Treatment of Tics

Grant Type
Grant Year
Institution Location
Institution Organization Name
Johns Hopkins
Investigators Name
Singer, Harvey, MD

Medications for tic suppression are generally reserved for patients whose tics are physically and psychosocially disabling. None of the available tic suppressing medicines are curative, and all may provide unwanted side effects. Classic neuroleptic drugs, antagonists of dopamine D2 receptors, are generally the mainstay of tic treatment, but side effects often limit their usefulness. Hence, there is an ongoing need to search for alternative, non-neuroleptic drugs for treating tics in TS. Levetiracetam is a broad spectrum anti-epileptic agent with many potential advantages including a high therapeutic index and a desirable pharmacokinetic profile and a drug that appears to cause only minor adverse effects. Recently, levetiracetam was shown to be beneficial for myoclonic epilepsy. Since TS tics are similar to myoclonus (i.e. quick, rapid jerks), a therapeutic trial for treatment of TS tics and chronic tic disorders is in progress with a view toward obtaining preliminary data on how effective this drug is in reducing tics. This study method is a double-blind, placebo-controlled, crossover, pilot project in which twenty patients between the ages of 8 to 16 years with TS will be enrolled. The study begins with a screening evaluation to insure that each subject satisfies all eligibility criteria, to allow subjects to become familiar with the assessment procedures and to obtain informed consent. Following the first visit, there is a doubleblind treatment period (levetiracetam/placebo) for an additional four weeks. Patients are formally evaluated at the beginning and end of each treatment phase and are followed by phone calls at weekly intervals. If successful, this preliminary study could lead to a much larger clinical study to find out whether levetiracetam is useful in the treatment of TS tics. Harvey Singer, M.D.; Dana Freeman, M.S., Pediatric Neurology, John Hopkins School of Medicine, Baltimore, MD Award: $30,000 Tourette Association of America Inc. – Research Grant Award 2003-2004