An open-label, prospective study of levetiracetam in children and adolescentes with Tourette syndrome

Fernández-Jaén, Alberto; Fernández-Mayoralas, Daniel Martı́n; Muñoz-Jareño, Nuria; Calleja‐Pérez, Beatriz

doi:10.1016/j.ejpn.2008.12.006

Cited by 33 publications

(11 citation statements)

References 22 publications

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“…In some revised studies, LEV appears to be effective in patients with comorbid ADHD, with improvement in Conners Scale ratings, behavior, and school performance, without concomitant treatments 50,54. In another study, LEV significantly reduced tic scores in TS patients with ADHD-associated comorbidity compared to patients without ADHD, most of them treated simultaneously with methylphenidate 53. Other studies did not demonstrate an improvement in ADHD or obsessive-compulsive behaviors with LEV 51,52…”

Section: Discussionmentioning

confidence: 93%

“…Although promising results were found in open-label studies,49,50,53 and in one randomized study54, other controlled trials could not demonstrate a benefit 51,52…”

Section: Discussionmentioning

confidence: 99%

“…A prospective, open-label study53 included 29 patients with TS aged 6–17 years. Patients received LEV with a dosage of approximately 30–40 mg/kg/day (maximum 2000 mg/day).…”

Section: Levetiracetammentioning

confidence: 99%

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Levetiracetam as an alternative therapy for Tourette syndrome

Granero¹

2010

NDT

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Tourette syndrome is a common childhood-onset neuropsychiatric disorder characterized by chronic tics and frequent comorbid conditions such as attention deficit disorder. Most currently used tic-suppressing drugs are frequently associated with serious adverse events. Thus, alternative therapeutic agents with more favorable side-effect profiles are being evaluated. New hypotheses and recent studies involving GABAergic system in the pathophysiology of Tourette syndrome suppose a reason for the evaluation of GABAergic drugs. Levetiracetam is a drug with an atypical GABAergic mechanism of action that might be expected to improve tics. Although trials performed to evaluate the efficacy of levetiracetam in the treatment of Tourette syndrome have provided conflicting results, it may be useful in some patients. The established safe profile of levetiracetam makes this drug an alternative for treatment if intolerance to currently used drugs appears, but additional evaluation with larger and longer duration controlled studies are necessary to assess the real efficacy in patients with Tourette syndrome.

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Section: Discussionmentioning

confidence: 93%

“…Although promising results were found in open-label studies,49,50,53 and in one randomized study54, other controlled trials could not demonstrate a benefit 51,52…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Levetiracetam as an alternative therapy for Tourette syndrome

Granero¹

2010

NDT

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“…Several open-label clinical trials have suggested that LEV may be a useful treatment for tics and may have a prolonged beneficial effect (Awaad et al, 2005;Fernandez-Jaen et al, 2009). In a study by Awaad et al (2005) in 60 children with TS, LEV led to a mean 20% reduction in tics, and improvement on both the YGTSS and CGI measures; 43 patients also improved in behavior and performance in school.…”

Section: Levetiracetammentioning

confidence: 99%

Emerging Treatment Strategies in Tourette Syndrome

Termine¹,

Selvini²,

Rossi³

et al. 2013

International Review of Neurobiology

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“…Several open-label clinical trials have suggested that levetiracetam may be a useful treatment for tics [29,30] and may have a prolonged beneficial effect. Despite these reports, a double-blind, placebo-controlled trial in 20 children showed no difference between levetiracetam and placebo [31], and levetiracetam was not as beneficial as clonidine [20].…”

Section: Levetiracetammentioning

confidence: 99%

Treatment of Tics and Tourette Syndrome

Singer

2010

Curr Treat Options Neurol

111

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Tics come in a variety of types and frequencies; have a waxing and waning course; are exacerbated by stress, anxiety, and fatigue; and often resolve or improve in the teenage or early adult years. Tourette syndrome requires the presence of chronic, fluctuating motor and phonic tics. In addition to tics, individuals with Tourette syndrome often have a variety of comorbid conditions such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depression and anxiety, episodic outbursts, and academic difficulties. These conditions often are a greater source of difficulty than the tics themselves. All patients with tics should be evaluated to assure proper diagnosis and to identify any associated psychopathology or academic difficulty. The treatment of tics begins with education of the patient and family, including discussions about the fundamentals of tics: their characteristics, etiology, outcomes, and available treatments. Therapy should be individualized based on the extent of impairment, available support, ability to cope, and the presence of other problems. Indications for the treatment of tics include psychosocial problems (loss of self-esteem, comments from peers, excessive worries about tics, diminished participation in activities), functional difficulties, classroom disruption, and physical discomfort. A variety of behavioral approaches can be used. Recent studies have emphasized the value of comprehensive behavioral intervention for tics (CBIT). Because habit reversal is the major component of CBIT, a cooperative patient, the presence of a premonitory urge, and a committed family are essential ingredients for success. If tic-suppressing medication is required, a two-tier approach and monotherapy are recommended. First-tier medications, notably the α-adrenergic agonists, are recommended for individuals with milder tics, especially persons with both tics and ADHD. Second-tier medications include various typical and atypical neuroleptics. Their sequence of prescription is often based on physician experience; I favor pimozide and fluphenazine. Atypical antipsychotics, such as risperidone and aripiprazole, have some advantages based on their side-effect profile and are particularly beneficial in individuals with significant co-existing behavioral issues. As will become readily apparent, however, few medications have been adequately assessed. Deep brain stimulation is an emerging therapy, but further data are required to optimize the location of electrode placement and stimulation and to determine precise indications for its implementation. Stimulant medication is effective in treating ADHD in children with tics; studies reducing concerns about its use are discussed.

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An open-label, prospective study of levetiracetam in children and adolescentes with Tourette syndrome

Cited by 33 publications

References 22 publications

Levetiracetam as an alternative therapy for Tourette syndrome

Levetiracetam as an alternative therapy for Tourette syndrome

Emerging Treatment Strategies in Tourette Syndrome

Treatment of Tics and Tourette Syndrome

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