Abstract Details

Title The Long-Term Efficacy and Safety of Fluphenazine in Patients with Tourette Syndrome

Topic Movement Disorders

Presentation(s) P02 - (-)

Poster/Presentation
Number 057

Objective

Background BACKGROUND: Tourette syndrome (TS) is a neurological disorder characterized by motor and phonic tics, often associated with neurobehavioral co-morbidities, such as attention deficit and hyperactivity disorder and obsessive-compulsive disorder. In addition to dopamine-depleting drugs, such as tetrabenazine, dopamine-receptor blocking drugs continue to be used in the treatment of tics (Jankovic J, Kurlan R. Mov Disord 2011;26:1149-56). Although haloperidol and pimozide are the only drugs currently approved by the FDA for the treatment of TS, the side effects, include tardive dyskinesia, limit the use of neuroleptics. Fluphenazine appears to have a high efficacy with fewer side effects.

Design/Methods DESIGN/METHODS: A retrospective chart review was performed in all the patients with TS that have been treated with fluphenazine over a 21 year period. Patients without at least one follow up encounter such as a clinic visit, telephone conversation or email, were excluded from this study. The response to treatment was rated 1 through 5 (1 = marked reduction in tics, 5 = worsening of tics).

Results RESULTS: A total of 160 patients, 131 male, were included in the study. Mean age at commencement of treatment was 17.6±12.2 years and the treatment was continued for a mean duration of 3.2±3.7 years (range: 0.02-16.8); mean dose 3.4±2.4 mg. Of all patients, 83.5% showed marked to moderate improvement (response rating 1 and 2) and none had worsening of symptoms; 21.3% discontinued treatment due to side effects. Commonest side effect was drowsiness/fatigue (22.2%), followed by weight gain(7.8%), akathisia(7%), depression (5.7%), dystonic reactions (3.5%). There were no cases of tardive dyskinesia.

Conclusions CONCLUSIONS: Our study shows that fluphenazine is safe and effective in patients with TS. Although tardive dyskinesia is potential risk it did not occur in this large cohort of patients treated with fluphenazine for up to 16.8 years.

Authors/Disclosures
Subhashie Wijemanne, MD (Parkinson's, Restless Legs & Movement Disorder Specialists) PRESENTER	No disclosure on file
Aleksandar Videnovic, MD, MSc, FAAN (MGH Neurological Clinical Research Institute)	Dr. Videnovic has nothing to disclose.
Joseph Jankovic, MD, FAAN (Baylor College of Medicine)	Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance, Allergan. The institution of Dr. Jankovic has received research support from Baylor College of Medicine. Dr. Jankovic has received research support from Abbvie. The institution of Dr. Jankovic has received research support from Abbvie.

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