Treatment

Mild cases may not need specific treatment. Neuroleptic medication is useful in treating the movement disorder. Haloperidol and pimozide are the most commonly prescribed drugs.(27) Sulpiride and the atypical neuroleptic risperidone may also be useful, but controlled trials have not been performed. The role of other atypical neuroleptics remains to be determined.

Obsessive-compulsive disorder and attention-deficit hyperactivity disorder are often more troublesome than the core features of Tourette syndrome and so it is important for them to be treated. Variable success has been achieved with behavioural techniques in the treatment of obsessive-compulsive disorder. SSRIs (fluoxetine) and risperidone also have a role.

The treatment of attention-deficit hyperactivity disorder is more controversial because stimulant drugs may exacerbate tics, but considerable benefits may follow the use of clonidine and stimulants such as methylphenidate, pemoline, and dextroamphetamine (see also ChapteL9.2..6).

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