An Open-Label Study of the Treatment Efficacy of Olanzapine for Tourette's Disorder

Background: An open-label trial was performed toexplore efficacy and safety of olanzapine, an atypicalneuroleptic with diverse receptor activity including bothdopamine-2 and serotonin-2A and -2C antagonism, for treatment ofTourette’s disorder.

Method: Ten adult patients aged 20 to 44 yearswith Tourette’s disorder were treated using an open-label,flexible dosing schedule for 8 weeks. Three patients whocontinued olanzapine were reevaluated after 6 months. Threesubjects were psychotropic medication naive, 5 patientsexperienced intolerable side effects with conventionalneuroleptics, and 2 patients had remote (>= 10 years)successful response to conventional neuroleptics. Tic severitywas rated by the Yale Global Tic Severity Scale; weight, vitalsigns, and adverse effects were assessed weekly.Electrocardiogram, laboratory studies, and comorbid symptoms,assessed by the Yale-Brown Obsessive Compulsive Scale and ADHDBehavior Checklist for Adults, were measured at baseline and atweek 8.

Results: Two of 10 patients prematurelydiscontinued olanzapine owing to excessive sedation. Of 8patients who completed the 8-week trial, 4 (50%) demonstratedreduction of global tic severity scores by >= 20 points, and 6(75%) demonstrated reductions by >= 10 points. No significantchanges in comorbid symptoms were demonstrated. Sedation, weightgain, increased appetite, dry mouth, and transient asymptomatichypoglycemia were the most common side effects. Tic improvementswere maintained in 3 patients reassessed 6 months later. Finalolanzapine dosages ranged from 2.5 mg to 20 mg daily (mean = 10.9mg/day).

Conclusion: This open-label study suggests thatolanzapine should be explored as a potential alternative toconventional neuroleptic medications for treatment of motor ticsand Tourette’s disorder.