Gilles de la Tourette's syndrome

Tics and central nervous system stimulants in twins and nontwins

Price, R. Arlen PhD
Leckman, James F. MD
Pauls, David L. PhD
Cohen, Donald J. MD
Kidd, Kenneth K. PhD

Department of Human Genetics (Drs. Price, Pauls, and Kidd) and Child Study Center (Drs. Leckman, Pauls, and Cohen), Yale University School of Medicine, New Haven, CT.

Address correspondence and reprint requests to Dr. Price, Department of Psychiatry, University of Pennsylvania, 305 Piersol North/G1, Philadelphia, PA 19104.

This research was supported in part by National Institutes of Health grants NS11648, HD03008, RR00125, the Yale Mental Health Clinical Research Center (MH30929), and grants from the Tourette Syndrome Association (Drs. Price and Leckman) and the John Merck Fund (Dr. Leckman).

Accepted for publication May 30, 1985.

Neurology 36(2):p 232-237, February 1986.

Article abstract

Thirty-four of 170 surveyed individuals with Tourette's syndrome (TS) were treated with CNS stimulants before age 18. In 24% of treated individuals, persistent exacerbation of tics was closely associated with treatment. In 3%, tic response was transient, and in 24%, tics were not obviously associated with treatment. Six pairs of monozygotic twins were discordant for stimulant treatment, and all untreated co-twins also developed TS. The number of individuals in whom stimulants permanently exacerbate tics may be small, but the risk appears to be real. Genetic vulnerability and duration and timing of treatment may mediate response.