Medications used for Tourette Syndrome
The following is a good general list and description of the medications used to treat the symptoms of Tourette Syndrome. Remember, there is no cure, but there are ways to lessen the issues. Tourettes World neither endorse or recommend against any of the medications listed. If I have been on one of the listed medications, you will see a comment after the drug name.
The good news is that if you must use a medication because of the severity of your case of Tourette Syndrome, there are some drugs that can be prescribed by a physician to help. Please make sure that your particular physician has working knowledge of Tourette Syndrome and how to treat it. Determining your treatment is an important part of the procedure. An uneducated physician may prescribe the wrong medications or prescribe the wrong dosage. EVERYONE has a different degree of severity of Tourette Syndrome symptoms. They range from very mild, to barely able to control ones body. A good, well informed physician will have researched this Neorological disorder and know the proper way to go about treatment for your individual case.
Many of the medications to control the tics also are used to control other things like blood pressure, restless legs syndrome, etc. Thus many TS (Tourette Syndrome) patients opt for living without taking meds.
There are Alternative Medicines - Holistic that some try. We will list some of them for informational purposes only.
Medication information for Tourette Syndrome, ADHD, ADD, and OCD
(All are common with people diagnosed with this disorder).
Non-Medication treatments (Behavior Programs - phychological - psychosocial)
Neuroleptics:
Anticonvulsants:
Antidepressants:
- Anafranil
- Cymbalta (very much like Effexor)
- Effexor
- Lithobid
- Luvox
- Norpramin
- Paxil
- Prozac
- Tofranil
- Wellbutrin
- Zoloft
Alpha Blockers (Antihypertensive):
Antianxiety (Sedative / Hypnotic ):
Beta Blockers (Antihypertensive):
CNS Stimulants:
Calcium Channel Blockers:
Alternative Medicine Information (by people who have tried it.)
Drug or Medication: Haloperidol (Haldol)
Drug Class: Neuroleptic
Action: Alters the effects of dopamine in the CNS. Also has anticholinergic and alpha-adrenergic blocking activity.
Expected Therapeutic Effect: decrease in motor and phonic tics.
Dosage: Initial dose 0.25mg at bedtime, increase by 0.25 to 0.50mg increments every 4-7 days. Average dose 3mg-4mg per day
Comments:
- Most side effects are dose relatedand can be resolved by decreasing dosage.
- Anti-parkinsonian medication (e.g.0.5mg/day of benztropine) can sometimes be used to alleviate side effects.
- Additive hypotension with antihypertensives, nitrates, or alcohol.
- Additive CNS depression with other CNS depressants.
- Concurrent use with epinephrine may result in severe hypotension and tachycardia.
- Acute encephalopathic syndrome may occur when used with lithium.
Adverse Effects: Motor drug-induced parkinsonism, akinesia, akathisia, acute dystonia, tardive dyskinesia, oculogyric crisis, extrapyramidal reactions, restlessness CNS sedation, drowsiness, decrease in cognitive function, anxiety Autonomic dry eyes/ mouth, urinary retention, diaphoresis, hypersalivation GI increase appetite, weight gain, anorexia, constipation, hepatitis Other dysphoria, social and school phobias, heat stroke, polydipsia, impotence, photosensitivity, rashes, galactorrhea, hyperpyrexia, anemia, leukopenia
Drug or Medication: Pimozide (Orap)
Drug Class: Neuroleptic
Action: Alters the effects of dopamine in the CNS. Possesses anticholinergic and alpha-adrenergic blocking activity.
Expected Therapeutic Effect: decrease in motor and phonic tics.
Dosage: Initial dose 1mg/day graduallyincreasing to a maximum of 6-10mg/day for children and 20mg/day for adults.Because of its long half-life (55hrs), a single daily dose may be feasible.
Comments:
- Better tolerated than haloperidol and probably is of equal efficacy.
- EKG routinely ordered to monitor rhythm abnormalities. (U waves, invertedT waves, and Q-T prolongation.) Not generally a problem.
Adverse Effects: In general, side effects are similar to haloperidol, but may be less severe and appear in fewer patients.
Drug or Medication: Fluphenazine (Prolixin)
Drug Class: Neuroleptic
Action: Alters the effects of dopamine in the CNS. Possesses anticholinergic and alpha-adrenergic blocking activity.
Expected Therapeutic Effect: decrease in motor and phonic tics.
Dosage: Initial adult dose 2.5mg 10.0 mg given in 6 to 8 hour doses. Dose may titrated upwards to a maximum of 40mg/day.
Comments:
- May cause false positive pregnancy test.
- May turn urine pink or reddish brown.
Adverse Effects: In general side effects are the same as those listed for haloperidol, but, like Orap, some patients tolerate it better.
Drug or Medication: Thiothixene (Navane)
Drug Class: Neuroleptic
Action: Alters the effect of dopamine in the CNS.
Expected Therapeutic Effect: decrease in motor and phonic tics.
Dosage: Initial dose in children over 12 is 2mg tid. Dose may be titrated up slowly to a maximum of 15mg/day Adults may start at 5mg bid. Usual dose 20mg-30mg/day, to a maximum of 60mg/day. Use in children under age of 12 is not recommended as no safe levels have been established.
Comments:
- In event hypotension occurs, epinephrine should not be usedas a pressor agent since a paradoxical further lowering of BP may result.
- EKG changes usually reverse and frequently disappear on continued therapy.
- May cause false positive pregnancy test.
Adverse Effects: Adverse affects similar to those for haloperidol. In addition, may have tachycardia, hypotension, non specific EKG changes, amenorrhea.
Drug or Medication: Chlorpromazine (Thorazine)
Drug Class: Neuroleptic
Action: Alters the effect of dopamine in the CNS. Possesses significant anticholinergic and alpha adrenergic blocking activity.
Expected Therapeutic Effect: decrease in motor and phonic tics.
Dosage: Initial dose for very young children 1/4mg/lb body weight. Older children doses up to 50mg. 100mg/daymaximum dose possible 500mg/d.
Comments:
- Sudden death, apparentlydue to cardiac arrest, has been reported.
- Skin pigmentation may occur following prolonged usage.
- Ocular changes characterized by deposition of fine particulate matter inthe lens and cornea.
Adverse Effects: In general, side effects same as forhaloperidol with an addition of two or three further symptoms. Noted EKG changes involving Q-T wave distortion, skin pigmentation changes, and eyechanges.
Drug or Medication: Trifluoperazine (Stelazine)
Drug Class: Neuroleptic
Action: Alters the effect of dopamine in the CNS. Possesses significant anticholinergic and alpha adrenergic blocking action.
Expected Therapeutic Effect: decrease in motor and phonic tics.
Dosage: Adult doses start at 1-2mg bid up to 40mg/day. Children 6-12 yrs. 1-2 mg daily or bid up to 6mg/day.
Comments:
- May cause falsepositive pregnancy test.
- May cause false positive liver bilirubin test.
- CBC and liver function tests should be monitored .
Adverse Effects: In general, side effects similar to haloperidol. Additionally may cause Q wave and Twave changes, blood dyscrasia.
Drug or Medication: Thioridazine (Mellaril)
Drug Class: Neuroleptic
Action: Alters the effects of dopamine in the CNS. Possesses significant anticholinergic and alpha adrenergic blocking activity.
Expected Therapeutic Effect: decrease in motor and phonic tics. Improvement in behavior.
Dosage: Adultdose of 25 mg 3 times daily. (Range of 20 200mg/day). Initial dose for children over 2 yrs. 0.5-3mg/kg/day in 2-3 divided doses (10mg 2-3 times daily).
Comments:
- Additive hypotension with other antihypertensive agent, nitrates, and acute ingestion of alcohol.
- Additive CNS depression with other CNS agents including antihistamines,narcotic analgesics, sedative/hypnotics.
- Lithium decreases blood level.
- May mask early signs of lithium toxicity and increases the risk of extra pyramidal reactions.
- Concurrent use with epinephrine may result in severe hypotension and tachycardia.
- Increased risk of agranulopcytosis with antithyroid agents.
Adverse Effects: In general, side effects similar to haloperidol. Additionally may cause hepatic toxicity.
Drug or Medication: Risperidone (Risperdal)
Drug Class: Neuroleptic
Action: Dopamine and serotonin receptor antagonist.
Expected Therapeutic Effect: decrease in motor and phonic tics. Improvement in behavior.
Dosage: Adult dose of 4-8mg daily
Comments: May be tolerated better than other neuroleptics,with fewer side effects.
Adverse Effects: In general sdie effects similar to haloperidol.
Drug or Medication: Clomipramine (Anafranil)
Drug Class: Anti-depressant Anti-obsessive
Action: Potentiates the effect of serotonin (antiobsessionaleffect) and norepinephrine in the CNS. Also has moderate anticholinergicproperties.
Expected Therapeutic Effect: decrease in obsessing, decrease in compulsions,possible decrease in tics, decrease in depression.
Dosage: Adult dose of 25mg/day initially increasing over 2 wk period to 100mg/day to a maximum of 250mg/day in divided doses. In children dose begins at 25mg/day initially increased over 2 wks to 3mg/kg/day or 100 mg/day or (whicheveris smaller). May further be increased to 200mg/day (whichever is smaller) in divided doses until stabilizing dose is reached, entire daily dose maybe given at bedtime.
Comments:
- May block therapeutic response to antihypertensives.
- Use with clonidine may cause hypertensive crisis.
- Additive CNS depression with other CNS depressants including alcohol, antihistamines,narcotic, analgesics, and sedative/hypnotics.
- Adrenergic and anticholinergic side effects may be additive with other agentsthat have the same properties.
- Nicotine or cigarette smoke may increase metabolism and decrease effectiveness.
Adverse Effects: Motor muscle weakness, extra pyramidal reactions CNS Seizures, sedation, drowsiness, lethargy, aggressive behavior. Autonomic dry eyes and mouth, blurred vision, vestibular disturbances, urinary retention GI constipation, weight gain, Other impotence, photosensitivity, gynecomastia, hyperthermia
Drug or Medication: Fluoxetine (Prozac)
Drug Class: Antidepressant
Action: Inhibits the uptake of serotonin in the CNS.
Expected Therapeutic Effect: decrease in obsessing, decrease in compulsions,possible decrease in tics, decrease in depression.
Dosage: Adult dose of 20mg/day in the morning. May increase by 20mg/day. Doses of 20mg/day should be given in 2 divided doses, 1 in the am and 1 at noon to a maximum of 80mg/day. Initial dose in children starts at 5mg/day and increases slowly.
Comments:
- Additive hypotension with antihypertensive agents.
- Additive CNS depression with other CNS depressants including alcohol, antidepressants,antihistamines, MAO inhibitors, narcotic analgesics, sedative/hypnotics.
- Phenobarbital may increase metabolism and decrease effectiveness.
- Concurrent use with lithium may produce acute encephalopathy, decreased chlorpromazine absorption, increased excretion of lithium, increased risk of extra pyramidal reactions.
- Decreases vasopressor response to epinephrine and norepinephrine.
- Concurrent use with beta blockers may result in inhibition of metabolismof one or both drugs producing an increased response.
- Increased risk of anticholinergic effects with other agents having anticholinergicproperties.
Adverse Effects: Motor extrapyramidal reactions, tardive dyskinesia, weakness, CNS seizures, sedation, anxiety, insomnia, headache, tremor, dizziness, fatigue, mania,abnormal dreams Autonomic dry eyes and mouth, urinary retention, blurred vision, excessive sweating GI Constipation, ileus, anorexia, diarrhea Other hypotension, tachycardia, photosensitivity, hyperthermia, rare suicidalideation, cough, flu-like syndrome, impotence
Drug or Medication: Sertraline HCL (Zoloft)
Drug Class: Antidepressant
Action: Potent selective inhibitor of neuronal serotoninreuptake and has only very weak effects on norepinephrine and dopamine neuronalreuptake. Does not inhibit MAO.
Expected Therapeutic Effect: decrease in depression, decrease in aggressive behavior, possible decrease in obsessions and compulsions.
Dosage: Initialadult dose of 50mg in once daily dose. May titrate up at 1 week intervalsto a maximum of 200mg/day.
Comments:
- Reports of fatal reactions withgiven with MAO inhibitors.
- Recommended that at least 14 days should elapse between usage.
- 32% decrease in valium clearance.
- 8% increase in prothrombin time. Should monitor upon initiation or discontinuation of use with Warfarin.
Adverse Effects: Motor ataxia, abnormal coordination, abnormal gait, tremor, dizziness CNS confusion, hyperesthesia, migraine, nystagmus, vertigo, twitching, insomnia Autonomic dry mouth, sweating, hypersalivation, urinary retention GI dysphagia, fecal incontinence, anorexia, weight gain, diarrhea Other aggressive reaction, amnesia, abnormal dreams, depersonalization, emotionallability, hallucination, gynecomastia, male sexual dysfunction, skin discoloration,skin odor, myalgia
Drug or Medication: Bupropion (Wellbutrin)
Drug Class: Antidepressant
Action: Decreases neuronal reuptake of dopamine inthe CNS. Diminished neuronal uptake of serotonin and norepinephrine (lessthan tricyclic antidepressants).
Expected Therapeutic Effect: decrease in depression, increased ability to concentrate. Possible decreasein obsessions and compulsions.
Dosage: Adult dose of 100mg twicedaily (morning and evening) initially; after 3 days may be increased to 100mg 3 times daily depending on response. If no response after 4 wks of therapy, may increase to a maximum daily dose of 450mg/day in divided doses. No single dose to exceed 150mg, wait at least 6hrs. between doses at the 300 mg/day dose or at least 4 hrs between doses at the 450mg/day dose. Safety not established in children.
Comments:
- Increased risk of adversereactions when used with levodopa or MAO inhibitors.
- Increased risk of seizures with phenothiazines, antidepressants, cessationof benzodiazepines, or cessation of alcohol.
- If dose is missed, omit dose and return to regular dosing schedule. Do notdouble dose. Increased risk of seizure.
Adverse Effects: Motor tremor, ataxia/incoordination, seizure, dyskinesia, vertigo CNS seizures, agitation, insomnia, psychoses, mania, headache, mania/hypomania,hallucinations, depression, memory impairment, depersonalization, mood instability Autonomic dry mouth GI nausea, change in appetite, weight gain or loss, constipation,dysphagia, stomatitis Other edema, EKG abnormalities, rashes, alopecia, gynecomastia, nocturia, vaginalirritation, sexual dysfunction, enuresis, urinary incontinence, menopause,shortness of breath, visual disturbance, flu-like syndrome.
Drug or Medication: Paroxetine HCL (Paxil)
Drug Class: Antidepressant
Action: Potentiation of serotonergic activity in the CNS resulting from inhibition of neural reuptake of serotonin. Very weak effects on norepinephrine and dopamine neuronal reuptake.
Expected Therapeutic Effect: decrease in depression, decrease in aggressive behavior.
Dosage: Initialadult dose should begin at 20mg/day. May titrate up in increments of 10mg/dayto a maximum of 50mg/day in a single morning dose.
Comments:
- Phenobarbitolmay decrease effectiveness.
- Cimetidine may increase concentrations in plasma by 50%.
- Co-administration of certain antidepressants (e.g., nortriptyline, amitriptyline,imipramine, desipramine and fluoxetine) should be approached with caution.
Adverse Effects: Motor myoclonus CNS insomnia, agitation, anxiety, headache, parethesia, CNS stimulation, asthenia, somnolence, dizziness Autonomic dry mouth, sweating, blurred vision GI constipation, increased or decreased appetite, dyspepsia, diarrhea Other fever, taste perversion, male sexual disturbance, urinary frequency, myalgia
Drug or Medication: Venlafaxine hydrochloride (Effexor)
Drug Class: Antidepressant
Action: Potent inhibitor of neuronal serotonin andnorepinephrine reuptake and weak inhibitors of dopamine reuptake.
Expected Therapeutic Effect: decrease in depression, possible decrease in obsessions and compulsions.
Dosage: Adult dose of 75mg/day, in 2-3 divided doses, taken with food. Dose may be increased to maximum of 225 mg/day in increments of up to 75 mg/day at intervals of no less than 4 days. Safety in children has not been established.
Comments:
- When discontinued dose should be tapered slowly over a 2 week period.
- At least 14 days should elapse between discontinuation of an MAOI and initiation of therapy with Effexor.
- In addition, at least 7 days should be alloweda fter stopping Effexor before starting an MAOI.
- Dose may need to be reduced by 50% for patients with hepatic impairment.
Adverse Effects: Motor tremor, hypertonia, ataxia, hyperkinesia, rare dystonia CNS Migraine, asthenia, somnolence, dizziness, nervousness, anxiety, insomnia Autonomic Dry mouth and eyes, blurred vision sweating GI Nausea, constipation, anorexia, diarrhea Other abnormal ejaculation/orgasm, impotence
Drug or Medication: Fluvoxamine (Luvox)
Drug Class: Antidepressant
Action: Potent inhibitor of presynaptic neuronal reuptake of serotonin
Expected Therapeutic Effect: decrease in depression, decrease in obsessions and compulsions.
Dosage: Adult dose of 50 mg to 300 mg/day in a single or divided dose.
Comments: The coadministration of fluvoxamine 100 mg/day and propranolol (Inderol) resulted in a five-fold increase in propranolol plasma concentration and a slightdecrease in heart rate.
Adverse Effects: Motor tremor, hypodinesia CNS somnolence, headache, agitation, dizziness, asthenia Autonomic dry mouth GI nausea/vomiting, constipation, anorexia. Other: insomnia, syncope
Drug or Medication: Desipramine HCL (Norpramin)
Drug Class: Tricyclic Antidepressant
Action: Blocks re-uptake of norepinephrine.Has significant anticholinergic properties.
Expected Therapeutic Effect: decrease in depression, increased ability toconcentrate, decrease in emotionally labile behavior.
Dosage: Usual adult dose is 100 200mg/day. May be further increased to a maximum of 300mg/day in a once daily dose. Lower dosages recommended for elderly and adolescent patients.
Comments:
- Should not be given in conjunction with, or within2 weeks of, treatment with MAO inhibitor; hyperpyretic crisis and deathhave occurred.
- Not recommended for children.
- Sudden death resulting from cardiac arrest has been reported in childrenusing this medication.
- Prolongation of QRS or QT wave intervals on EKG are significant for toxicity.
Adverse Effects: Motor incoordination, ataxia, extrapyramidal symptoms, seizures CNS disorientation, anxiety, insomnia, nightmares, hypomania, drowsiness, Autonomic dry mouth, blurred vision, urinary retention, sweating, urinary frequency GI anorexia, constipation, weight gain Other itching, photosensitivity, gynecomastia, galactorrhea, decreased libido,alopecia, EKG changes
Drug or Medication: Imipramine (Tofranil)
Drug Class: Tricyclic Antidepressant
Action: Potentiates the effect of serotoninand norepinephrine. Has significant anticholinergic properties.
Expected Therapeutic Effect: decrease in depression, increased ability toconcentrate, decrease in emotionally labile behavior.
Dosage: Adultdose 25-50mg 3-4 times daily to a maximum of 300mg/day. Total dose may begiven at bedtime. Children below age 6 years, 25mg once daily before bedtime, may increase by 25mg at weekly intervals to 50mg in children. Children over age 12 mayincrease does to 75mg/day.
Comments:
- May cause hypotension and tachycardiawhen used with MAO inhibitors. Avoid concurrent use-discontinue 2 weeksprior to start of imipramine.
- May prevent therapeutic response to most antihypertensive.
- May cause severe hypertension when used with clonidine. Avoid concurrentuse.
Adverse Effects: CNS drowsiness, sedation, confusion, agitation, hallucination, insomnia Autonomic dry mouth and eyes, blurred vision, urinary retention GI constipation Other photosensitivity, hypotension, EKG changes, arrhythmias
Drug or Medication: Buspirone HCL (Buspar)
Drug Class: Antianxiety
Action: Binds to serotonin and dopamine receptors inthe brain (enhances serotonin transmission while blocking dopamine transmission). Increases norepinephrine metabolism in the brain.
Expected Therapeutic Effect: decrease in emotionally labile behavior.
Dosage: Adult dose 15mg/day in 3 divided doses, may be increased by 5mg/day at 23 day intervals, to a maximum of 60mg/day. Usual dose is 20 30mg/day.
Comments:
- Usewith MAO inhibitors may result in hypertension.
- Avoid use with alcohol
Adverse Effects: Motor incoordination, tremor, fatigue CNS dizziness, insomnia, nervousness, drowsiness, excitement, personality changes,paresthesia, numbness Autonomic blurred vision, nasal congestion, altered taste or smell, dry mouth andeyes, sweating, urinary hesitancy GI diarrhea, constipation, nausea. Other: myalgia, chest pain, palpitations, tachycardia, hypo or hypertension
Drug or Medication: Diazepam (Valium)
Drug Class: Antianxiety Sedative-Hypnotic
Action: Depresses the CNS, probably by potentiatinggamma-aminobutyric acid (GABA), an inhibitory neurotransmitter.
Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferentpathways.
Expected Therapeutic Effect: decrease in anxiety.
Dosage: Adult 2-10mg2-4 times daily. Children older than 6 months 1-2.5mg 3-4 times daily.
Comments:
- Concurrent use with alcohol, antidepressants, antihistamines, and narcotic analgesicsresults in additive CNS depression.
- Cimetidine, oral contraceptives, disulfiram, fluoxetine, ionized, propranolol, ketoconazole, metoprolol, propoxphene, or valproic acid may enhance its actions.
- Sedative effects may be decreased by theophylline.
Adverse Effects: CNS dizziness, drowsiness, lethargy, hangover, paradoxical excitation, mental depression, headache Autonomic blurred vision GI nausea, constipation. Other: respiratory depression, tolerance, psychological dependence, physical dependence.
Drug or Medication: Clorazepate (Tranxene)
Drug Class: Antianxiety Sedative-Hypnotic Benzodiazepine
Action: Acts at many levels in the CNS to produceanxiolytic effect and CNS depression (by stimulating inhibitory GABA receptors).Produces skeletal muscle relaxation (by inhibiting spinal polysynaptic afferentpathways).
Expected Therapeutic Effect: decrease in anxiety.
Dosage: Adult dose 7.5-15mg 2-4 times daily.May be given in a single dose of up to 22.5mg at bedtime. Children 9-12 yr. 7.5mg twice a day. May increase no more than 7.5mg/dayat weekly intervals, not to exceed 60mg/day.
Comments: May decreaseefficacy of levodopa. Other drug interactions similar to diazepam.
Adverse Effects: Side effects similar to those of diazapam.
Drug or Medication: Alprazolam (Xanax)
Drug Class: Sedative-Hypnotic Benzodiazepine
Action: Acts at many levels in the CNS to produceanxiolytic effect. Depresses the CNS, probably by potentiating gamma aminobutyricacid (GABA), an inhibitory neurotransmitter.
Expected Therapeutic Effect: decrease in anxiety.
Dosage: Adult dose 0.25-0.5mg 2-3 times dailynot to exceed 4mg/day.
Comments: Drug interactions same as Tranxene.
Adverse Effects: Side effects similar to those of diazapam.
Drug or Medication: Carbamazepine (Tegretol)
Drug Class: Anticonvulsant
Action: Decreases synaptic transmission in the CNS.
Expected Therapeutic Effect: Decrease in aggressive behavior, decrease in emotionally labile behavior.
Dosage: Initial adult dose of 200mg 2 times daily or 100mg 4 times daily. May titrate upto therapeutic levels in the range of 800-1200mg/day in divided doses every 6 to 8 hrs. to a maximum of 1g/day. Children 6-12 yrs. 200mg/day in 2-4 divided doses. May increase until therapeutic levels in the range of 400-800mg/day to a maximum of 1g/day.
Comments:
- May decrease effectiveness of oral contraceptives, benzodiazepines, and other anticonvulsants.
- Concurrent use (within 14 days) of MAO inhibitors may result in hyperpyrexia,hypertension, seizure and death.
- Verapamil, diltiazem, propoxphene, or erythromycin increases carbamazepine levels and may cause toxicity.
Adverse Effects: Motor ataxia CNS vertigo, drowsiness, psychosis, visual hallucinations Autonomic blurred vision, urinary retention or hesitancy GI hepatitis. Other: Congestive heart failure, syncope, hypo- or hypertension, photosensitivity,aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, leukocytosis, eosinophilia
Drug or Medication: Clonazepam (Klonipin)
Drug Class: Anticonvulsant
Action: Produces anticonvulsant and sedative effects in the CNS. Mechanism is unknown but is probably similar to that of benzodiazepines, has a high affinity for the y- gamma aminobutyric acid (GABA) receptor,increasing synaptic serotonin.
Expected Therapeutic Effect: decrease in aggressive behavior, decrease in emotionally labile behavior,decrease in tics.
Dosage: Initial adult dose not to exceed 1.5mg given in 3 divided doses, may increase by 0.5-1mg every 3 days. Total maximum dose of 20mg/day. Children up to 10 yr or 30kg 0.01-0.03mg/kg not to exceed 0.05mg/kg given in 2-3 daily doses; increase by no more than 0.5mg every 3 days until therapeutic blood levels are reached. Maximum dose of 0.2mg/kg/day.
Comments:
- Longterm effects on growth and maturation in children not known.
- Concurrent use of alcohol, antidepressants, antihistamines, and narcotic analgesics will result in additive CNS depression.
- Cimetidine, oral contraceptives, disulfiram, fluoxetine, ionized, propranolol, ketoconazole, metoprolol, propoxphene, or valproic acid may enhance its actions.
- Sedative effects may be decreased by theophylline.
Adverse Effects: Motor Ataxia, choreiform movements CNS drowsiness, behavioral changes, abnormal eye movements, nystagmus Autonomic increased respiratory secretions, urinary retention, hypersalivation GI constipation, hepatitis Other: palpitations, anemia, leukopenia, thrombocytopenia, eosinophilia, fever,increase in libido
Drug or Medication: Clonidine (Catapres)
Drug Class: Antihypertensive Alpha blocker
Action: Stimulates alpha adrenergic receptors in the CNS. Result is inhibition of cardioacceleration and vasoconstriction center. Adrenergic agonist, but stimulates inhibitory neurons in the CNS. In higher doses ceases inhibitory effects and causes an increase in sympathetic arousal.
Expected Therapeutic Effect: decrease in tics, increased attention, decrease in emotionally labile behavior.
Dosage: Initial adult PO dose 0.1mg twice a day. Usual dose is 0.2-1.2mg/day in 2-3 divided doses. Adult transdermal patch is 1-3mg applied weekly. Initial dose in children starts at 0.15-0.4mg/day in divided doses (startwith 0.05mg at bedtime for a few days); also available in transdermal patch.
Comments:
- Additive sedation with CNS depressants including alcohol, antihistamines, narcoticanalgesics, and sedative/hypnotics.
- Withdrawal phenomenon may be exaggerated by concurrent tricyclic antidepressants.
- Do not discontinue abruptly.
Adverse Effects: CNS: drowsiness, nightmares, nervousness, depression. Autonomic: dry mouth and eyes GI: constipation Other: hypotension, bradycardia, palpitations, impotence, weight gain, withdrawal phenomenon
Drug or Medication: Guanfacine (Tenex)
Drug Class: Antihypertensive Alpha blocker
Action: Stimulates CNS alpha adrenergicreceptors, resulting in decreased sympathetic outflow.
Expected Therapeutic Effect: decrease in motor tics, improvement in mood.
Dosage: Adult dose of1 mg daily given at bedtime, may be increased if necessary at 3 4wk intervalsup to 3 mg/day.
Comments:
- Additive hypotension with other antihypertensiveagents, nitrates, and acute ingestion of alcohol.
- Additive CNS depression may occur with other CNS depressants, including alcohol, antihistamines, narcotic analgesics, tricyclic antidepressants,and sedative/hypnotics.
Adverse Effects: CNS drowsiness, weakness, fatigue, dizziness, headache, insomnia, depression Autonomic dry mouth GI constipation, abdominal pain, nausea Other Tinnitus, dyspnea, impotence
Drug or Medication: Propranolol (Inderol)
Drug Class: Antihypertensive Beta blocker
Action: Blocks stimulation of beta1 and beta 2 receptorsites.
Expected Therapeutic Effect: decrease in emotionally labile behavior, decrease in rage attacks, decrease in obsessive symptoms, possible improvement in tics.
Dosage: Adult dose of 60mgSR 2 times daily. Safety not established in children.
Comments:
- Concurrent use with amphetamines,cocaine, ephedrine, epinephrine, norepinephrine, phenylephrine, or pseudoephedrinemay result in excess alpha-adrenergic stimulation, hypertension, and bradycardia.
- May produce hypertension within 14 days of MAO inhibitor.
- Cimetidine may decrease metabolism and increase the effects of propranolol.
- Do not withdraw abruptly.
Adverse Effects: CNS fatigue, weakness, depression, insomnia, dizziness Autonomic dry eyes, blurred vision, nasal stuffiness GI constipation, diarrhea, nausea, vomiting Other bronchospasm, bradycardia, pulmonary edema, hypo or hyperglycemia, impotence, Raynaud's phenomenon
Drug or Medication: Nifedipine (ProcardiaXL)
Drug Class: Antihypertensive Calcium channel blocker
Action: Acts on slow calcium channels invascular smooth muscle and myocardium, producing vasodilation.
Expected Therapeutic Effect: decrease in tic symptoms.
Dosage: Adult dose of 10mg 3 times daily Safety not established in children.
Comments:
- Additive hypotensionwith antihypertensives.
- May increase blood levels and risk of toxicity with digoxin.
- Cimetidine may slow metabolism and lead to toxicity
Adverse Effects: CNS dizziness, giddiness, headache Autonomic flushing, warmth, sweating, nasal congestion, sore throat GI nausea, constipation, flatulence Other dyspnea, cough, hypotension, wheezing, tachycardia, arrhythmias, fever,heart failure, muscle cramping
Drug or Medication: Verapamil (Isoptin)
Drug Class: Antihypertensive Calcium channel blocker
Action: Inhibits calcium transport into myocardialand vascular smooth muscle cells, resulting in inhibition of excitationcontraction coupling and subsequent contraction.
Expected Therapeutic Effect: decrease in motor tics, improvement in mood.
Dosage: Adult dose of 20mg 3 times daily. Children should not initiate therapy in a dose greater than 5mg.
Comments:
- Mayincrease or decrease lithium levels.
- Increase risk of toxicity from theophylline.
- Increased risk of bradycardia, congestive heart failure, and arrhythmiaswhen used with beta-adrenergic blocking agents or disopyramide.
- Additive hypotension with antihypertensive agents, acute ingestion of alcohol,nitrates, or quinidine.
Adverse Effects: CNS dizziness, headache, fatigue GI constipation,abdominal discomfort Other bradycardia, hypotension, edema, heart block, sinus arrest, pulmonary edema
Drug or Medication: Methylphenidate HCL (Ritalin )
Drug Class: CNS stimulant
Action: Produces CNS and respiratory stimulation withweak sympathomimetic activity.
Expected Therapeutic Effect: increased attention span in attention deficit disorder.
Caution: May cause increase in motor tics. May cause onset of TS.
Dosage: Adultdose to be given 30 40 minutes prior meals 2 times daily of 20-30mg/dayto a maximum of 60mg/day. Sustained release tablets may be substituted ifthe equivalent dose over 8 hrs. is the same. Children older than 6 years of age should initiate therapy at 5mg beforebreakfast and before lunch, may increase by 5-10mg at weekly intervals toa maximum of 60mg/day. Safety has not be established in children under 6 yrs.
Comments:
- Adversereactions can usually be reduced by decreasing dosage or omitting dose inafternoon or evening.
- Toxic psychosis has been reported.
- Long term therapy may stunt growth.
- Treatment should be assessed periodically. Improvement may be sustainedwhen the drug is either temporarily or permanently discontinued.
- Drug treatment usually may be discontinued after puberty.
Adverse Effects: Motor increase in motor tics, restlessness, tremor, hyperactivity, akathisia,dyskinesia CNS insomnia, irritability, dizziness, headache, nervousness Autonomic blurred vision, dry mouth GI nausea, anorexia, cramps, constipation, weight loss Other leukopenia, fever, tachycardia, palpitation, hyper or hypotension, metallictaste
Drug or Medication: Dextro amphetamine (Dexedrine)
Drug Class: CNS stimulant
Action: Produces CNS stimulation by releasing norephinephrinefrom nerve endings.
Expected Therapeutic Effect: increased attention span in attention deficit disorder.
Caution: May cause increase in motor tics. May cause onset of TS.
Dosage: Children3-5 yrs. 2.5mg/day, may increase by 2.5mg at weekly intervals. Children over 6 yrs. 5 10mg/day in 1-2 doses, increase by 5mg at weeklyintervals.
Comments:
- Additive adrenergic effects with other adrenergicagents.
- Use with MAO inhibitors can result in hypertensive crisis.
- Large doses of ascorbic acid decreases effect.
- Phenothiazines may decrease effect.
- May antagonize the response to antihypertensive.
- Increased risk of cardiovascular side effects with beta blockers or tricyclicantidepressants.
Adverse Effects: Side effects similar to those of Ritalinwith an addition of psychological dependence, physical dependence, increasedlibido, decrease in seizure threshold
Drug or Medication: Pemoline (Cylert)
Drug Class: CNS stimulant
Action: Produces CNS stimulation, which may be mediatedby dopamine.
Expected Therapeutic Effect: increase in attention span in attention deficit disorder.
Caution: May cause increase in motor tics. May cause onset of TS.
Dosage: Childrenover 6 yrs. 37.5mg initially as single morning dose, may be increased 18.75mg at weekly intervals until optimum response is achieved. Usual maintenance dose is 56.25 75mg/day
Comments:
- Long term therapy may stunt growth.
- Additive CNS stimulation with other CNS stimulants or adrenergics, including decongestants
- Take medication in a.m. to avoid sleep disturbances.
Adverse Effects: Side effects similar to those of Ritalin with the addition of dyskinetic movements, sweating, decrease in seizure threshold.
Drug or Medication: Lithium (Lithobid)
Drug Class: Antimanic Antidepressant
Action: Alters cation transport in nerve and muscle.May also influence re-uptake of neurotransmitters.
Expected Therapeutic Effect: given concurrently with antidepressant may enhance response to serotonergic agents
Dosage: Adult dose of 9001200mg/day in 3 or 4 divided doses (usual dose 300mg 3-4 times daily). Extended-release dosage may be given twice daily.
Comments:
- May prolong the action ofneuromuscular blocking agents.
- Encephalopathic syndrome may occur with haloperidol.
- Diuretics, methyldopa, probenecid, indomethacin, and other nonsteroidal anti-inflammatory agents may increase the risk of toxicity.
- Lithium may decrease the effects of chlorpromazine.
- Chlorpromazine may mask early signs of lithium toxicity.
- Large changes in sodium intake (medication or food) may alter the renalelimination of lithium. Increasing sodium intake will increase renal excretion.
Adverse Effects: Motor muscle weakness, rigidity, hyperirritability, ataxia, tremors, psychomotorretardation CNS headache, impaired memory, lethargy, drowsiness, confusion, seizure, restlessness,aphasia, hyperirritability Autonomic tinnitus, blurred vision, dry mouth GI nausea, anorexia, epigastric bloating, abdominal pain, diarrhea, metallictaste, weight gain Other EKG changes, hypotension, arrhythmias, polyuria, nephrogenic diabetes insipidus,renal toxicity, acneiform erruption, folliculitis, pruritis, diminishedsensation, alopecia, hyper- or hypothyroidism, goiter, hyperglycemia, leukocytosis
References: Physicians' Desk Reference 1992, 46th edition.
Davis's Drug Guide For Nurses, third edition 1993, Judith Hopfer Deglin,PharmD, April Hazard Vallerand,
MSN, RN, F.A. Davis Company, Philadelphia
Alternative Medicine research and trials:
I have done a lot of research concerning alternative medicines. I believe in some cases it may work, others not. There is no clear or concise evidence either way.
Be warned, may companies offering Alternative Medicines (Holistic) offer claims that are simply untrue. Most people that try them have one thing to say. It worked, the company got my money. In other words, they found no relief, but the false or misleading marketing claims caused some people to try their products. The only results were loss of finances and who knows the affects on the body. So read the following with care and and open mind.
Two people that I have come to respect very much that are dedicating their time and efforts to alternative treatments for Tourette Syndrome are Ms. Sheila Rodgers and Ms. Bonnie Grimaldi. If you do any Internet research on alternative or natural treatment for Tourette's on the Internet and you don't come accross these ladies, your research is simply not complete. Both have become Internet legends in this area and are doing it for a good cause.
Sheila Rodgers is affiliated with the Association for Comprehensive NeuroTherapy (ACN and publishes a quarterly newsletter called Latitudes which focuses on any alternative or integrative treatment that may be beneficial for TS and accompanying disorders, including homeopathy, EEG biofeedback, craniosacral therapy, etc.
Bonnie is a Medical Technologist and mother of a teenage son with Tourette Syndrome, OCD and ADD. After an extensive period of reading and evaluating scientific literature, Bonnie felt her teenage son with Tourette's might do better on a regiment of specific vitamins, minerals, amino acids, etc. and developed a daily regiment that has greatly minimized her sons ticcing (he is tic free most of the time). Bonnie believes in her regiment and has made it public on the Internet and has graciously allowed us to publish it below. She has received responses from 50 families who have tried it with varying degrees of success. Like all remedies for these disorders, treatment with natural supplements does not work for everyone. But many children and adults have found success using supplements to treat their TS. Degree of success ranges from minimal reduction of tics to becoming completely tic free. You will need to read Sheila and Bonnie's sites to gain a better understanding of the scientific and technical reasons this form of treatment holds merit.
My inclusion of this material should not be considered a professional medical opinion or endorsement. I am not a medical professional. My reason for including this information is simple -- I want to make readers of this website aware that their are other treatment options for people with Tourette's and other disorders -- options beyond the potent drugs and pharmaceuticals currently used for these disorder. These options work for some children and do not work for others.
If your child is not responding to drugs or wants to stop taking drugs, you owe it to yourself to read more about treatment with supplements, diet changes and nutrition so that you can make an informed decision. Should you elect to try taking supplements for Tourette's or orther disorders, never abandon meds for these conditions without being under a doctor's care. These meds should not be stopped abruptly, as most require a slow "weaning off" process to prevent doing serious harm or damage to one's health.
More information about Bonnie and Sheila and the work they are doing can be found below:
[Bonnie Grimaldi] [Sheila Rodgers]
Bonnie Grimaldi, BSMT (ASCP)
Medical Technologist
Columbus, Ohio
Mother of teenage son with Tourette Syndrome,
Obsessive Compulsive Disorder, and ADD
My son, aged 17 with TS/OCD/ADD has tried almost all of the medications known for these disorders with negative results and intolerable side effects. In Dec. '95, I started him on vitamins and minerals after carefully researching the scientific literature (I am a medical technologist with a graduate course in biochemistry) on TS/OCD/ADD and autism (which I believe is part of the spectrum).
I meshed this with antecdotal info from doctors that post to alt.support.tourette and from parents of autistic kids on an autism list and of TS kids on alt.support.tourette concerning diet, allergies, etc. I have based my regiment on my findings and are safe according to the PDR and other sources I have gathered at the OSU medical library.
My son's tics began to be disruptive in school in the 5th grade and we started the beginning of a 2 year trial of various combinations of medications. By the end of this trial, he was failing in school, was being removed from the classroom at least 3 times a day for disruptive tics, and was developing serious behaviour and attentional problems.
We made a decision at a very low point, when we were considering residential treatment, to go med free and try vitamins and minerals instead. Within 2 days of starting the regimen, he was not disruptive anymore. By the next year (8th grade) he was totally tic free in school with greatly reduced tics at home also. He is now tic free most of the time.
Our family life is full again! His tics used to interfere with car trips, restaurant outings, church, etc. due to his being triggered by his father's and brother's voices and gestures, and coughs by anyone. He had also developed tics to sounds of footsteps and of a hand hitting a desk, etc.
Now he is an honor student and made the varsity swim team as a freshman and has lettered twice. In the 8th grade he was a Junior Olympian is USS swimming. When he forgot to take his supplements once in 8th year, I got a call from his teachers asking what had changed. In his 9th grade year, he didn't take his supplements for a week when he went on a trip with his swim team and it took him a month to recover. His teachers have asked for my help with other students and the school has recorded "vitamin therapy" as a viable treatment option on his IEP.
I will post the individual supplements that work for my son and many others who have tried it. I am using the below health food store to ship my supplements. Cas has the exact list of what to order. She also has a tablet splitter for $5.76 available.
Cas
The Natural Health Food Store
809 E. Race
Searcy, Arkansas 72143
(501)-268-9585
casrifkin@hotmail.com
I have heard from over 50 families with TS and they all have had success, some more, some less. My regimen is a safe guideline to follow and the exact amounts of my recommended supplements vary slightly with different brands. The program that I have set up with Cas works great. Some B complex and antioxidant formulas may differ slightly from what is on this webpage, but avoid copper and iron containing supplements (unless lab tests have found a deficiency in one of these).
The latitudes web page has info on TS and nutritional therapy that is similar to mine.
I would like you to take a few moments to fill out a survey concerning your use of supplements for the treatment of TS symptoms. Just e-mail survey@latitudes.org and latitudes will send you a survey through the postal service. This is very important to do if you would like to see research studies done concerning TS and supplemental therapy.
Here is my list of supplements that I recommend:
Make sure that the vitamins are naturally coated, and that no sugar, preservatives, artificial colors or flavors, chemical solvents, or specific things that you may be allergic to are on the label. "USP" on the label is preferred.
The following recommendations are for those 10 yrs to adult (children 6 to 10 should follow the dosages in brackets), who have normal, healthy liver, gallbladder, kidney and heart functions and are not pregnant or nursing, or have active peptic ulcers. Always consult your physician before taking any supplements to be sure. DISCLAIMER: This approach may not work for everyone.
In the morning:
1. 1200 mg lecithin granules (1 to 2 tablespoons) or gel cap
2. Antioxidants
-Beta Carotene 10,000 I.U. (optional)
-Vitamin E 400 I.U. [200 I.U. for children 6-10]
-Vitamin C 500 mg.
-Zinc 30 mg.
-Selenium 15 mcg. (optional)
-Coenzyme Q10 30 mg. (optional)
-Glutathione (reduced) 25 mg.
3. Vitamin B complex capsule (B50 - 11
B factors) [children 6 to 10 should use a tablet form and cut it in 1/2 for half the dose]
-Vit B1 (thiamine) 50 mg
-Vit B2 (riboflavin) 50 mg
-Vit B6 (pyridoxine HCl) 50 mg
-Vit B12 (Cyanocobalamin) 50 mcg
-Biotin 100 mcg
-Pantothenic Acid 50 mg
-Folic Acid 50 to 400 mcg
-Niacinamide 50 mg
-Inositol 50 mg
-PABA 50 mg
-Choline 50 mg
4. NO FLUSH niacin (inositol nicotinate) a 500 mg capsule or tablet is divided in 1/2 to get 250 mg. [children 6 to 10 should divide it in 1/4 to get 125 mg.]
5. Solary Grapenol Grapeseed Extract (1 mg. per pound body weight a day)
6. DHA 500 mg.
Afternoon:
50 mg of niacin tablets (regular, since no-flush doesn't come in 50 mg doses) [children 6 to 10 should cut this tablet in 1/2 for 25 mg] may be taken three times during the day as needed for tics - decrease dose if flushing occurs. Flushing feels like a sunburn and may itch or it may be a mild rash. This lasts only 15 minutes and is not an allergic reaction and is not harmful.
DO NOT EXCEED 500 MG/DAY (250 MG/DAY FOR CHILDREN 6 TO 10) OF TOTAL NIACIN (NO-FLUSH NIACIN, NIACINAMIDE IN B COMPLEX, AND REGULAR NIACIN) More can be taken with a doctor's supervision - my son is supervised and takes 1600 mg of no-flush niacin a day.
Just before bed:
1. Amino Acid Chelated Calcium-Magnesium tablets
780 mg calcium
468 mg magnesium
(6 tablets of Schiff brand provides this - some prefer to take 2 tablets in the a.m. and 4 in the p.m.)
2. Vitamin B complex capsule/tablet - follow same directions as above
3. Taurine 500 mg
I give B complex for a balance of the B vitamins, so that a deficiency in one doesn't occur.
Foods that contain tyramine should be avoided if increasing symptoms- they are chocolate (large quantities), aged cheese, soy sauce, red wine, raisins, canned fish, pickled herring, chicken livers, cured meats, and most alcoholic beverages. They interfere with MAO inhibitors, if you are taking this kind of antidepressant, with severe consequences to your health -hypertensive crisis. Tyramine is a monoamine which is eliminated by monoamine oxidase (MAO). If MAO is inhibited, then tyramine is not broken down, releasing stores of norepinephrine, which have been found to be increased in TS in several studies. Tyramine also is an inhibitor of pyridoxal kinase, which decreases the active form of vitamin B6 in the body.
Go to an allergist and get tested for food allergies. Eliminate these foods from your diet to see if this helps, or try an elimination diet without the allergy testing. (Of course, get tested for respiratory allergies also!). Recent studies have shown that food allergies or sensitivites causes hyperactivity in the majority of cases. The allergy connection is also implicated in TS.
Cut out aspartame (NutraSweet). The high phenylalanine blocks other "Large Neutral Amino Acids", such as valine, leucine, isoleucine, tryptophan, tyrosine, histidine, and methionine from entering the brain. Aspartic acid, which is in aspartame, is an excitatory amino acid, which can act as a false transmitter, substituting for glutamic acid (glutamate). MSG (monosodium glutamate) should be avoided, also because of its glutamate portion, which excites neurons. Avoid caramel color, vanillin and yellow #5 (tartrazine). These inhibibit B6 activity.
Avoid pseudephedrine (Sudafed) containing decongestants and antihistamines. Eliminate other dyes (especially azo dyes) that may cause adverse reactions - especially red dye # 40. Caffeine should be eliminated. It is a methylated xanthine stimulant of the catecholamines, which are already stimulated in TS.
Essential fatty acids can be found in DHA and trout, crappie, haddock, sea bass, salmon, cod, and/or cold water halibut (the fatty fish).
Don't ingest many foods high in sugar. The best diet approach may be a semi vegetarian diet, which provides a balance of carbohydrates and protein, recognizing that adolescents need more protein than adults.
For information about my hypothesis and why I have chosen these supplements for my program please see:
Bonnie Grimaldi: Hypothesis.
Bonnie Grimaldi, BSMT (ASCP)
Medical Technologist, Laboratory
Bachelor of Science in Medical Technology from the University of Akron in Akron, Ohio Dec 1977
Graduate course in Biochemistry at the University of Akron
Certified by the American Society for Clinical Pathologists
MT(ASCP) # 115060 Aug. 1977.
e-mail: BonnieGr@aol.com
Sheila Rodgers and Latitudes is a quarterly newsletter published by the Association for Comprehensive NeuroTherapy (ACN). Latitudes focuses on any alternative or integrative treatment that may be beneficial for TS and accompanying disorders, including homeopathy, EEG biofeedback, craniosacral therapy, etc.
The goals of Latitudes include:
-
To present current information in an professional and understandable format
-
To add significantly to the ongoing call for unbiased, comprehensive research in nondrug therapies
-
To promote mutual respect between conventional and nonconventional practitioners
-
To encourage a movement whereby medical politics will yield to medical partnership, with broad-based, interdisciplinary boards being established to collaborate on these disorders--- disorders for which a multi-faceted approach is expected to prove most successful
Latitudes contains cutting-edge articles from physicians, letters from readers, updates on research and clinical findings, information from other networks, editorials, and reviews of publications and new products. Each issue has articles that specifically address autism, Tourette syndrome, attention disorders and learning problems.
One of the most frequent inquiries received by the Association for Comprehensive NeuroTherapy relates to the use of supplements for Tourette syndrome (TS). While anecdotal reports and physician case studies indicate that many TS individuals have benefited from nutritional supplementation (often along with dietary and/or allergy control), studies have not been conducted in this area. Families tend to experience frustration and a lack of direction when confronting this issue.
Reader response is invited. We've included an example article below -- Nutrition and TS, a reprint of an article that first appeared in the newsletter Latitudes.
Nutrition and TS
by Albert Robbins, D.O.
From a nutritional standpoint, this is what I advise my patients who suffer from neurologic allergy (allergy affecting the nervous system):
Hidden food and chemical allergy may make one nutritionally imbalanced. (Recommended readings: Help for the Hyperactive Child, by William Crook, M.D. and Is This Your Child’s World? by Doris Rapp, M.D.)
Medical history and physical examination may reveal signs of nutritional deficiencies. These should be evaluated by appropriate medical tests and be properly treated.
There is no specific vitamin deficiency that has been associated with Tourette syndrome. However, individuals may be helped by nutritional supplementation for vitamins, minerals, and amino acids. Individuals with neurologic symptoms may benefit from a B-complex vitamin supplement and supplementary minerals (nutritionally balanced).
Antioxidants are recommended to everyone in a form that is well tolerated. (Vitamins A, C, E, and selenium).
Folic acid is important for neurologic functioning and detoxification.
Hypoglycemia, food allergy, food addiction and nutritional imbalances are related.
Caffeine should be eliminated from the diet.
Some allergic individuals have vitamin dependencies. This means they require higher amounts of certain nutrients to function optimally. Some chemically sensitive individuals benefit from nutritional supplements due to multiple problems. (Recommended reading: Chemical Sensitivity, Vols. I and II, by William Rea, M.D., 1992, Lewis Publishers, Boca Raton, Florida. Phone (800)
272-7737)
Niacinamide (vitamin B3) acts like a natural tranquilizer on the nervous system.
Zinc is a “tranquilizer” mineral. Eat foods high in zinc and magnesium. Zinc and magnesium supplements may be very helpful in diminishing irritability and muscle twitching.
Avoid all chemicallized foods. Avoid artificial sweeteners, colors, and dyes.
Eat organically grown foods whenever possible. Avoid pesticide exposure.
Some individuals benefit from vitamin B injections (preservative-free), especially vitamin B12 (hydroxocobalamin).
Intravenous vitamin C and magnesium is helpful in some cases of neurologic hypersensitivity; vitamin B6, B1 and calcium have also been observed to be beneficial.
Albert Robbins, D.O., M.S.P.H.
400 South Dixie Hwy, Suite 210, Boca Raton, FL 33432; phone 561.395.3282
Jon Pangborn, Ph.D., received a doctoral degree in chemical engineering. After working in nuclear research and the field of alternative fuels, he became interested in the biochemistry of human metabolism. He developed a novel procedure for evaluating amino acid analyses and founded Bionostics, Inc., as a consulting organization. He is a holder of 9 U. S. patents, and author of over 200 publications and presentations. Dr. Pangborn is Fellow of the American Institute of Chemists, is certified as a Clinical Nutritionist, and serves regularly on the faculties of the American Academy of Environmental Medicine and the American Academy of Otolaryngic Allergy. He works closely with Dr. Bernard Rimland in the area of autism research, and also maintains a database on Tourette syndrome.
Albert Robbins, D.O., F.A.A.E.M. Robbins Environmental Medical center is located in Boca Raton, Florida. He is a Fellow of the American Academy of Environmental Medicine, and Board Certified by the American Osteopathic Board of Preventive Medicine/Occupational/Environmental Medicine. He is a Diplomate of the International Board of Environmental Medicine and the American Board of Environmental Medicine. Dr. Robbins specializes in the diagnosis and treatment of asthma, allergies, and chemical sensitivity. Publications have focused on chemically-induced illnesses. He serves as editor of the Environmental Physician. Dr. Robbins has demonstrated a particular interest in Tourette syndrome and attention deficit disorders.
To the Tourette Syndrome Community — Families, Friends, and Physicians:
url: http://www.latitudes.org/tssurvey.html
A New Survey
Many people with Tourette syndrome (TS) are trying vitamin regimens in an effort to control symptoms. Some are also making dietary changes, addressing allergies, or using other techniques. Due to reports of success by some families, many in the TS community would like to see rigorous scientific studies conducted of these approaches. If studies establish a link between any of these approaches and TS symptoms, this would help introduce non-drug alternatives to a wider audience.
To encourage the research establishment to fund and conduct such studies, concerned parents have initiated a move to formally collect information on supplement use and symptoms of TS and related conditions. We ask that you please take a few minutes to printout, complete and return the survey form below, even if you have not pursued nutritional therapy.
In developing this survey, we consulted experts in Tourette syndrome, nutrition, and epidemiology, all of whom made valuable suggestions. We need a large number of responses to maximize the value of the survey. We hope we can count on your participation.
The Association for Comprehensive NeuroTherapy (ACN) will collect the survey forms. ACN is a nonprofit organization devoted to the exploration of complementary treatments for Tourette Syndrome and other neurological conditions. All responses will remain confidential. ACN will remove all identifying information before sharing data from surveys with the research community.
Thank you!
BJ Mantel, Bonnie Grimaldi, and Sheila Rogers (for ACN)
Survey of Supplements and Tourette Syndrome (35 kb)
http://www.latitudes.org/FinalSurvey.pdf